Kosin Med J.  2019 Dec;34(2):146-151. 10.7180/kmj.2019.34.2.146.

A Case of Peritoneal Sarcomatoid Mesothelioma with Absence of Occupationl Exposure to Asbestos

• Yoo SH
• Kim HM
• Park JK
• Kim MS
• Yi SY

• KMID: 2467975
• DOI: http://doi.org/10.7180/kmj.2019.34.2.146

Abstract

Sarcomatoid mesothelioma is not very common, mesothelioma is directly attributable to occupational asbestos exposure, with 90% of cases showing a history of exposure. A 66-year-old male was admitted with an abdominal pain that persisted for 3 weeks. He had no abdominal mass. Computed tomography showed soft tissue thickening in perihepatic space and nodularities in omentum and peritoneum with ascites. There was no absolute diagnosis evidence in ascites analysis. Although the pathology of ascites was free for malignancy, the patient underwent omentum biopsy for definitive diagnosis. In laproscopic exploration, there was omental cake, peritoneal nodular seeding. It was suspected cancer carcinomatosis. Immunohistochemical findings suggested that it was sarcomatoid masothelioma. This is the rare case of a peritoneal sarcomatoid mesothelioma, without any exposure to asbestos.

Keyword

Mesothelioma; Sarcoma

MeSH Terms

Abdominal Pain
Aged
Asbestos*
Ascites
Biopsy
Carcinoma
Diagnosis
Humans
Male
Mesothelioma*
Omentum
Pathology
Peritoneum
Sarcoma
Asbestos

Figure

• 

  Fig. 1 Computed tomography reveals soft tissue thickening in perihepatic space and peritoneum (thin arrows) with omental nodularities. There are small amounts of ascites in perihepatic space (thick arrows).

• 

  Fig. 2 In laproscopic exploration, there was omental cake, peritoneal nodular seeding . It was suspected cancer carcinomatosis.

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  Fig. 3 (Left) Histologically, the tumor consists of pleomorphic spindle cells arranged in fascicles or haphazard distribution, with focal chronic inflammatory infiltrate (H&E, ×200). (Right) In immunohistochemical stain, the tumor cells manifest positive reactivity for pancytokeratins (×200).

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