A summary of peritoneal mesothelioma

Peritoneal mesothelioma (peritoneal mesothelioma) in the primary peritoneal mesothelial organizations and epithelial tumors, clinical rarely see. Pathology, may be divided into adenomatous mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).

Peritoneal mesothelioma (peritoneal mesothelioma) in the primary peritoneal mesothelial organizations and epithelial tumors, clinical rarely see. Pathology, may be divided into adenomatous mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign.

Cystic mesothelioma more common in women, cause unknown, occurred in the surrounding pelvic or annex, a single or multiple cystic mass; patients often palpable abdominal mass and treatment. PMM malignant mesothelioma of about 30 percent of its occurrence is also closely related to exposure to asbestos, about 5 percent of patients have a history of exposure; asbestos fiber intake by mouth, through the intestinal wall and translocation to the peritoneal disease. From exposure to asbestos-diagnosed, the disease incubation period of up to 25 to 40 years. However, domestic 1951 to 1993 20 PMM literature reports 161 cases, only one case of a history of exposure to asbestos. No history of exposure to asbestos in the crowd, the incidence rate of about 1 / 1 million years, and some may be infected with the virus and genetic factors. Foreign PMM reported one case of patients over 40 years ago, glial contact with thorium dioxide (Thorotrast). PMM often occurred in more than 40-year-old male. Dirty floor or layer can Li and peritoneal tumor can be a direct violation of abdominal, pelvic organ; 50 percent to 70 percent of patients with lymphoid and (or) blood distant metastasis as liver, kidney and adrenal gland, lung, bone and lymph nodes, etc. .

This lack of specificity of clinical manifestations, may have abdominal pain, constipation, abdominal distension, weight loss and other obstruction performance. Physical examination can be found ascites or abdominal mass, and so on. Ascites for effusion, some bloody. The disease often misdiagnosed as tuberculosis peritonitis, recurrent spontaneous peritonitis, inflammation or mesenteric peritoneal metastasis, and so on. Ascites hyaluronic acid increased significantly,> 0.8 g / L were found only in PMM. Ascites exfoliated cells also check some value, but often difficult to judge. Serum carbohydrate antigen -125 (CA125) increased to help diagnosis of the disease. B-ultrasound and CT findings of diversity, are typical of peritoneal irregular thickening, omentum adhesion was Bingzhuang, mesenteric a tissue sample; CT can also display enhanced pancreatic mass-week, intra-abdominal or substantive diffuse large mass, And violations of bowel and mesentery, or peritoneal nodules, or a cystic mass, multi-with varying degrees of ascites. Ultrasound or CT-guided biopsy a certain value. PMM diagnostic laparoscopy is a simple and effective method, peritoneal microscope, omentum nodules and diffuse plaques, and open heart biopsy pathological examination. We upon the one case of 83-year-old male patient laparoscopy, peritoneal biopsy pathology report of skin cell proliferation, biological and chemical immunity by the organization after the inspection confirmed PMM. Butchart and other PMM will be divided into four: I period, the tumor confined to the peritoneum; Ⅱ period of intra-abdominal lymph node cancer; Ⅲ period, to the abdominal tumor metastasis outside; Ⅳ period, distant blood transfer. Categories will help choose the treatment.

PMM so far no effective standardized treatment. Poor prognosis, diagnosis after the median survival period for one year, survived more than two years to less than 20%. Mainly from the evil of quality or obstruction, and rarely cause of death related to cancer metastasis.