Peritoneal mesothelioma originated in the epithelium and peritoneal mesothelial organization, its pathology can be divided into: adenomatoid tumors, cystic mesothelioma and malignant mesothelioma three. Peritoneal mesothelioma is a rare malignant cancer, the incidence rate of 1 / 1 million, more than occurred in middle-aged men and women less morbidity, the occurrence and exposure to asbestos-related.
Patients, female, 52 years old, "abdominal distention more than 20 days" on October 21, 2004 into the internal medicine. Patients in the hospital 20 days ago had no incentive to appear abdominal distention, aggravated sexual, no fever, night sweats, no abdominal pain, Nacha, without losing weight, without Niaohuang, Wu Shuang lower extremity edema. Ascites pumped in a local hospital, did not find cancer cells. Kin of the past. Menstrual: 13,7 / 30, 48-year-old, color is, in the middle, with dysmenorrhea. Motherhood history, G2P2L2. Investigations of: the body temperature of 36.8 ℃, pulse 84 / min, breathing 21 times / min, blood pressure 112/80 mmHg. Mucosa with no yellow skin, the body did not touch on superficial lymph nodes. Normal heart and lung, abdominal Penglong, no varicose veins, abdominal soft, no tenderness and anti-Tiaotong, liver and spleen did not touch, mobility Zhuoyin (+). Gynecological hospital later, ultrasound examination showed: the uterus and dual-zone annex no obvious abnormalities, a large number of ascites. Tumor Series: CA 125> 500u/ml. On October 26, 2004 as professor of gynecology consultation, gynecological examination: genital development of normal, vaginal smooth, cervical normal size, yet smooth. Ping-uterus, the size of normal activities. After the dome touched nodules 1.5 cm × 1.0cm. Two-Annex Central anomaly, ascites due to consider the possibility of gynecological cancer, a clear diagnosis, decided to laparoscopic exploration of the patients agreed to surgery, in the October 26, 2004 into the gynecology.
Gynecology turn after October 28, 2004 in the general anesthesia for exploratory laparoscopy, in the view of the uterus before-and normal size, the size of normal bilateral ovarian, uterine, bladder-pack peritoneal membrane that milky white bar, the net Film, intestine and other congestive peritoneal layer. Aspiration of yellow ascites 6500 ml, in the pelvic peritoneum layer and the left ovary for biopsy and membrane bar submission, the result, the left ovary benign lesions, the layer of peritoneal not rule out the possibility of malignant mesothelioma, ascites shedding cytology: check see Cancer (cancer). On the situation with family members, with pots of intra-abdominal found no mass, the decision to biopsy, after a clear diagnosis after further treatment. Peritoneal wash, home of a drainage operation smoothly, and after infusion of antibiotics to prevent infection. Postoperative pathology report: peritoneal malignant mesothelioma (more than skin-based). Immunohistochemistry was: MC (+), CK (+), CA125 (-), CA19-9 (-). After the open drainage, drainage to a total of 2800 ml ascites, after review blood, liver function, kidney function was normal, on October 18, 2004 in mind, guardianship downlink PT chemotherapy, after a smooth, no abnormal reaction.
Discussion
Peritoneal mesothelioma originated in the epithelium and peritoneal mesothelial organization, its pathology can be divided into: adenomatoid tumors, cystic mesothelioma and malignant mesothelioma three. Peritoneal mesothelioma is a rare malignant cancer, the incidence rate of 1 / 1 million, more than occurred in middle-aged men and women less morbidity, the occurrence and exposure to asbestos-related. It was reported 60 percent to 80 percent of patients with a history of exposure to asbestos, a number of cases often without a clear history of exposure to asbestos, radiation therapy and may be related to chronic stimulation of the peritoneum. Some viruses may also cause mesothelioma reasons. Peritoneal mesothelioma clinical manifestations are not specific, the inspection positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology development and pathology, immunohistochemistry and electron microscopy raising the level of diagnosis, more and more cases of the former during his lifetime or clear diagnosis. Peritoneal mesothelioma mainly with tuberculosis peritonitis, intra-abdominal cancer metastasis, the other in the primary peritoneal, omentum identification of the tumor. So far, peritoneal mesothelioma is still a lack of effects of treatment, the overwhelming majority of scholars that include surgical resection, radiation and chemotherapy after the comprehensive measures. As a malignant tumor, if there was not the cause of ascites, clinical doctors ruled out ovarian cancer, gastrointestinal malignancies and the transfer of intra-abdominal diseases such as tuberculosis peritonitis should be taken into account the possibility of peritoneal malignant mesothelioma, early Biopsy even laparotomy, to win a clear diagnosis of treatment time.
Patients, female, 52 years old, "abdominal distention more than 20 days" on October 21, 2004 into the internal medicine. Patients in the hospital 20 days ago had no incentive to appear abdominal distention, aggravated sexual, no fever, night sweats, no abdominal pain, Nacha, without losing weight, without Niaohuang, Wu Shuang lower extremity edema. Ascites pumped in a local hospital, did not find cancer cells. Kin of the past. Menstrual: 13,7 / 30, 48-year-old, color is, in the middle, with dysmenorrhea. Motherhood history, G2P2L2. Investigations of: the body temperature of 36.8 ℃, pulse 84 / min, breathing 21 times / min, blood pressure 112/80 mmHg. Mucosa with no yellow skin, the body did not touch on superficial lymph nodes. Normal heart and lung, abdominal Penglong, no varicose veins, abdominal soft, no tenderness and anti-Tiaotong, liver and spleen did not touch, mobility Zhuoyin (+). Gynecological hospital later, ultrasound examination showed: the uterus and dual-zone annex no obvious abnormalities, a large number of ascites. Tumor Series: CA 125> 500u/ml. On October 26, 2004 as professor of gynecology consultation, gynecological examination: genital development of normal, vaginal smooth, cervical normal size, yet smooth. Ping-uterus, the size of normal activities. After the dome touched nodules 1.5 cm × 1.0cm. Two-Annex Central anomaly, ascites due to consider the possibility of gynecological cancer, a clear diagnosis, decided to laparoscopic exploration of the patients agreed to surgery, in the October 26, 2004 into the gynecology.
Gynecology turn after October 28, 2004 in the general anesthesia for exploratory laparoscopy, in the view of the uterus before-and normal size, the size of normal bilateral ovarian, uterine, bladder-pack peritoneal membrane that milky white bar, the net Film, intestine and other congestive peritoneal layer. Aspiration of yellow ascites 6500 ml, in the pelvic peritoneum layer and the left ovary for biopsy and membrane bar submission, the result, the left ovary benign lesions, the layer of peritoneal not rule out the possibility of malignant mesothelioma, ascites shedding cytology: check see Cancer (cancer). On the situation with family members, with pots of intra-abdominal found no mass, the decision to biopsy, after a clear diagnosis after further treatment. Peritoneal wash, home of a drainage operation smoothly, and after infusion of antibiotics to prevent infection. Postoperative pathology report: peritoneal malignant mesothelioma (more than skin-based). Immunohistochemistry was: MC (+), CK (+), CA125 (-), CA19-9 (-). After the open drainage, drainage to a total of 2800 ml ascites, after review blood, liver function, kidney function was normal, on October 18, 2004 in mind, guardianship downlink PT chemotherapy, after a smooth, no abnormal reaction.
Discussion
Peritoneal mesothelioma originated in the epithelium and peritoneal mesothelial organization, its pathology can be divided into: adenomatoid tumors, cystic mesothelioma and malignant mesothelioma three. Peritoneal mesothelioma is a rare malignant cancer, the incidence rate of 1 / 1 million, more than occurred in middle-aged men and women less morbidity, the occurrence and exposure to asbestos-related. It was reported 60 percent to 80 percent of patients with a history of exposure to asbestos, a number of cases often without a clear history of exposure to asbestos, radiation therapy and may be related to chronic stimulation of the peritoneum. Some viruses may also cause mesothelioma reasons. Peritoneal mesothelioma clinical manifestations are not specific, the inspection positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology development and pathology, immunohistochemistry and electron microscopy raising the level of diagnosis, more and more cases of the former during his lifetime or clear diagnosis. Peritoneal mesothelioma mainly with tuberculosis peritonitis, intra-abdominal cancer metastasis, the other in the primary peritoneal, omentum identification of the tumor. So far, peritoneal mesothelioma is still a lack of effects of treatment, the overwhelming majority of scholars that include surgical resection, radiation and chemotherapy after the comprehensive measures. As a malignant tumor, if there was not the cause of ascites, clinical doctors ruled out ovarian cancer, gastrointestinal malignancies and the transfer of intra-abdominal diseases such as tuberculosis peritonitis should be taken into account the possibility of peritoneal malignant mesothelioma, early Biopsy even laparotomy, to win a clear diagnosis of treatment time.
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