Obstet Gynecol Sci.  2018 Jan;61(1):170-174. 10.5468/ogs.2018.61.1.170.

Benign multicystic peritoneal mesothelioma treated with laparoendoscopic single site surgery: a case report and review of the literature

• Cha KS
• Choi YH
• Lee YS
• Park EK

• KMID: 2420168
• DOI: http://doi.org/10.5468/ogs.2018.61.1.170

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is rare and difficult to diagnose before surgery. We report a case of BMPM incidentally discovered during laparoendoscopic single site surgery (LESS) for treatment of a pelvic mass. A 47-year-old Korean menopaused woman presented to our outpatient clinic with a pelvic mass. She had a history of right ovary cystectomy with adhesiolysis at a local hospital in 2010. Imaging study of the pelvis revealed a multilocular cystic mass. LESS was performed and multiple grapelike clusters of cysts were seen in the uterus, cul-de-sac, both adnexa, pelvic wall, and omentum. The appendix was grossly free. Frozen biopsy confirmed BMPM. Excision of multiple cyst clusters of cysts, resection of the uterus with both adnexa, appendectomy, omentectomy, and adhesiolysis were performed with LESS. She is well for 2 years with no recurrence. BMPM should be included in the differential diagnosis when small multichamber cystic mass is found on ultrasonography.

Keyword

Mesothelioma; Surgery; Multilocular cystic mass

MeSH Terms

Ambulatory Care Facilities
Appendectomy
Appendix
Biopsy
Cystectomy
Diagnosis, Differential
Female
Humans
Mesothelioma*
Middle Aged
Omentum
Ovary
Pelvis
Recurrence
Ultrasonography
Uterus

Figure

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  Fig. 1 (A) Ultrasonography of the pelvis shows a multilocular cystic mass in the pelvic cavity. (B) Magnetic resonance imaging shows small multiple nodules about 1 cm in size with low signal intensity in the anterior and posterior uterine wall on T2-weighted images.

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  Fig. 2 (A) On laparoscopy, multiple grapelike clusters of cysts appear to originate from the peritoneum. (B) multiple cysts are attached to the uterus and both adnexa. (C) Additional small cysts are seen on the omentum, small bowel mesentery, and appendix. (D) Calretinin immunohistochemical staining (×100) reveals a positive reaction.

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