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Peritoneal Mesothelioma: An Unusual Cause of High-Protein Ascites.

Kaspar M - ACG Case Rep J (2015)

Bottom Line: We present a case illustrating the workup and diagnosis of peritoneal sarcomatous mesothelioma as an unusual etiology of intestinal obstruction and high-protein ascites in an otherwise healthy man.In many cases, localized disease can be treated to cure with surgery and intraperitoneal chemotherapy.Advanced disease is often treated for palliation of symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA.

ABSTRACT
We present a case illustrating the workup and diagnosis of peritoneal sarcomatous mesothelioma as an unusual etiology of intestinal obstruction and high-protein ascites in an otherwise healthy man. This rare disorder is diagnosed based on immunohistochemistry, which is necessary to differentiate it from other rare sarcomatous carcinomas. In many cases, localized disease can be treated to cure with surgery and intraperitoneal chemotherapy. Advanced disease is often treated for palliation of symptoms.

No MeSH data available.


Related in: MedlinePlus

Diagnostic laparoscopy showing “frozen abdomen” with fibrotic peritoneum and encased bowel (black arrow), and focal areas concerning for tumor implant (white arrow).
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Figure 2: Diagnostic laparoscopy showing “frozen abdomen” with fibrotic peritoneum and encased bowel (black arrow), and focal areas concerning for tumor implant (white arrow).

Mentions: Exploratory laparoscopy to identify the cause of his small bowel obstruction was performed. Gross examination of the peritoneum revealed a frozen abdomen with bowel wall and peritoneal thickening in addition to areas concerning for focal tumor implant (Figure 2). Pathology from peritoneal biopsies stained positive for pancytokeratin, Wilms tumor suppressor gene 1 (WT1), and calretin, and negative for CD34, most consistent with a diagnosis of sarcomatous peritoneal mesothelioma. Chest CT performed after diagnosis did not reveal any thoracic disease.


Peritoneal Mesothelioma: An Unusual Cause of High-Protein Ascites.

Kaspar M - ACG Case Rep J (2015)

Diagnostic laparoscopy showing “frozen abdomen” with fibrotic peritoneum and encased bowel (black arrow), and focal areas concerning for tumor implant (white arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612766&req=5

Figure 2: Diagnostic laparoscopy showing “frozen abdomen” with fibrotic peritoneum and encased bowel (black arrow), and focal areas concerning for tumor implant (white arrow).
Mentions: Exploratory laparoscopy to identify the cause of his small bowel obstruction was performed. Gross examination of the peritoneum revealed a frozen abdomen with bowel wall and peritoneal thickening in addition to areas concerning for focal tumor implant (Figure 2). Pathology from peritoneal biopsies stained positive for pancytokeratin, Wilms tumor suppressor gene 1 (WT1), and calretin, and negative for CD34, most consistent with a diagnosis of sarcomatous peritoneal mesothelioma. Chest CT performed after diagnosis did not reveal any thoracic disease.

Bottom Line: We present a case illustrating the workup and diagnosis of peritoneal sarcomatous mesothelioma as an unusual etiology of intestinal obstruction and high-protein ascites in an otherwise healthy man.In many cases, localized disease can be treated to cure with surgery and intraperitoneal chemotherapy.Advanced disease is often treated for palliation of symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA.

ABSTRACT
We present a case illustrating the workup and diagnosis of peritoneal sarcomatous mesothelioma as an unusual etiology of intestinal obstruction and high-protein ascites in an otherwise healthy man. This rare disorder is diagnosed based on immunohistochemistry, which is necessary to differentiate it from other rare sarcomatous carcinomas. In many cases, localized disease can be treated to cure with surgery and intraperitoneal chemotherapy. Advanced disease is often treated for palliation of symptoms.

No MeSH data available.


Related in: MedlinePlus