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Case report
peer-reviewed

A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy



Abstract

Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare subtype of epithelioid mesothelioma, which is usually seen in young women without a history of asbestos exposure, and generally, has an indolent course. The relative rarity of this neoplasm in males prompted us to report this case of a well-differentiated papillary mesothelioma of the peritoneum in a 36-year-old man.

The patient, who had no history of asbestos exposure, presented with abdominal pain and ascites of unknown etiology. Computed tomography showed abundant ascites with nodules of the peritoneal cavity. Laparoscopic examination revealed a large number of white miliary nodules diffusely covering the peritoneum. Pathology revealed a diagnosis of well-differentiated papillary mesothelioma of the peritoneum, based on histomorphology and immunohistochemistry. The patient started chemotherapy with cisplatin and pemetrexed. After six cycles of chemotherapy, the effectiveness of this chemotherapy was checked by only the computed tomography. PET scan was not used because it is not routinely recommended in WDPMP. Few data are currently available in the literature regarding the performance of the PET scan in WDPMP. Nine months later, the patient was free of symptoms.

Based on reviewing the literature and our observations in this case, consultation of other pathologists is highly recommended to discern WDPMP from other disseminated peritoneal diseases, in order to offer the most effective and safe therapeutic strategy. Chemotherapy should be strongly considered if the tumor is unresectable and accompanied by symptoms. Cisplatin and pemetrexed chemotherapy could be a promising therapeutic choice.



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Case report
peer-reviewed

A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy


Author Information

Aziz Bazine Corresponding Author

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Mohamed Fetohi

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco.

Tariq Namad

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Asmae Benzekri

Department of Pathology, Nations-Unies Pathology Center, Rabat, Morocco

Brahim Zainoun

Department of Radiology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Rachid Tanz

Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco

Mohamed Ichou

Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy


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Case report
peer-reviewed

A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy

  • Author Information
    Aziz Bazine Corresponding Author

    Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

    Mohamed Fetohi

    Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco.

    Tariq Namad

    Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

    Asmae Benzekri

    Department of Pathology, Nations-Unies Pathology Center, Rabat, Morocco

    Brahim Zainoun

    Department of Radiology, Military Hospital Moulay Ismaïl, Meknès, Morocco

    Rachid Tanz

    Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco

    Mohamed Ichou

    Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: March 19, 2017

    DOI

    10.7759/cureus.1104

    Cite this article as:

    Bazine A, Fetohi M, Namad T, et al. (March 19, 2017) A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy. Cureus 9(3): e1104. doi:10.7759/cureus.1104

    Publication history

    Received by Cureus: January 05, 2017
    Peer review began: January 12, 2017
    Peer review concluded: March 12, 2017
    Published: March 19, 2017

    Copyright

    © Copyright 2017
    Bazine et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare subtype of epithelioid mesothelioma, which is usually seen in young women without a history of asbestos exposure, and generally, has an indolent course. The relative rarity of this neoplasm in males prompted us to report this case of a well-differentiated papillary mesothelioma of the peritoneum in a 36-year-old man.

The patient, who had no history of asbestos exposure, presented with abdominal pain and ascites of unknown etiology. Computed tomography showed abundant ascites with nodules of the peritoneal cavity. Laparoscopic examination revealed a large number of white miliary nodules diffusely covering the peritoneum. Pathology revealed a diagnosis of well-differentiated papillary mesothelioma of the peritoneum, based on histomorphology and immunohistochemistry. The patient started chemotherapy with cisplatin and pemetrexed. After six cycles of chemotherapy, the effectiveness of this chemotherapy was checked by only the computed tomography. PET scan was not used because it is not routinely recommended in WDPMP. Few data are currently available in the literature regarding the performance of the PET scan in WDPMP. Nine months later, the patient was free of symptoms.

Based on reviewing the literature and our observations in this case, consultation of other pathologists is highly recommended to discern WDPMP from other disseminated peritoneal diseases, in order to offer the most effective and safe therapeutic strategy. Chemotherapy should be strongly considered if the tumor is unresectable and accompanied by symptoms. Cisplatin and pemetrexed chemotherapy could be a promising therapeutic choice.



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Create a free account to continue reading this article.

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Aziz Bazine, M.D.

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

For correspondence:
bazineaziz@gmail.com

Mohamed Fetohi

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco.

Tariq Namad

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Asmae Benzekri

Department of Pathology, Nations-Unies Pathology Center, Rabat, Morocco

Brahim Zainoun

Department of Radiology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Rachid Tanz

Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco

Mohamed Ichou

Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco

Aziz Bazine, M.D.

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

For correspondence:
bazineaziz@gmail.com

Mohamed Fetohi

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco.

Tariq Namad

Department of Medical Oncology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Asmae Benzekri

Department of Pathology, Nations-Unies Pathology Center, Rabat, Morocco

Brahim Zainoun

Department of Radiology, Military Hospital Moulay Ismaïl, Meknès, Morocco

Rachid Tanz

Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco

Mohamed Ichou

Department of Medical Oncology, Military Hospital Mohammed V, Rabat, Morocco