Peritoneal Mesothelioma


Given its rarity, there are no established guidelines for the treatment of peritoneal mesothelioma. The modern approach to malignant peritoneal mesothelioma includes cytoreductive surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), intraperitoneal chemotherapy, and intravenous chemotherapy. These are often used in conjunction and in a complementary fashion, and this multifaceted approach has significantly improved outcomes when compared to intravenous chemotherapy alone. For instance, the reported median survival time for patients with stage IV mesothelioma as reported by the American Cancer Society is 12 months; however, with adequate cytoreduction, intraperitoneal, and intravenous chemotherapy combined, some authors report 10-year survival rates projected at nearly 75%.



With peritoneal mesothelioma, fluid may collect inside your abdomen (this is called ascites). If too much fluid collects, it makes your abdomen swell. This can be uncomfortable and heavy.



The latest advances in medical technology allow doctors to diagnose this disease earlier than ever before, yet experienced cancer doctors can struggle to diagnose it accurately. In fact, the process can take months.

Recent international data on the incidence of peritoneal mesothelioma are available from Eurocim, a collaboration of European population-based cancer registries , and from the SEER program of the United States . Only sparse data are available from the other countries. Figure 1 reports the most recent data from selected nationwide European cancer registries and the SEER registries; at this level of aggregation, age-standardized incidence rates among men range from 0.5 to about three cases per million population. However, higher rates are reported in smaller areas with widespread past use of asbestos, such as the harbor city of Genoa, Italy (age-standardized rate in men in 1995, 5.5 per million). In most populations, rates among women are in the range 0.2–2 per million and are lower than in men; although in some countries, such as Sweden, rates are comparable in the two sexes. A correlation in incidence rates exists between the two sexes (correlation coefficient of 1991–1995 rates on the basis of 41 European and nine USA populations covered by cancer registry, 0.41; P = 0.003).

Early symptoms of peritoneal mesothelioma can include abdominal pain or swelling, and diarrhea or constipation. Unfortunately, some patients don’t experience any symptoms until tumors spread. This scenario makes treating the disease hard and surviving it even harder.

What patients will have to pay out-of-pocket for treatment will largely depend on their insurance coverage and where they are treated. Even with good coverage, it can still be difficult to keep up with all the bills with any secondary expenses, continued care after treatment, and the loss of income many patients face as they can no longer work.

Since asbestos is the only known cause of mesothelioma, people diagnosed with peritoneal mesothelioma or their surviving family members may be eligible to file a claim and possibly receive compensation to use towards medical costs and lost income. It’s important to speak with a mesothelioma lawyer to learn about your legal rights as soon as possible, as there is a limited statute of limitations in most states.

In this article we report a case of a 77 year old man who presented with a one week history of breathlessness and a right pleural effusion. An incidental right upper quadrant abdominal mass was noted leading to ultrasound and subsequent CT scans. A large subhepatic mass was identified, in addition to pleural calcification and thickening. Biopsy and histological examination of the abdominal mass suggested a spindle cell tumour, most likely a mesothelioma. Thoracocentesis and cytology of the pleural fluid confirmed the diagnosis of a malignant mesothelioma. Our patient is a retired dairy farmer. A detailed occupational history revealed likely asbestos exposure when he worked as a plumber, approximately 50 years ago.

The process of diagnosing peritoneal mesothelioma is similar to other types of mesothelioma. It starts with a thorough examination of your medical history, occupational history and overall physical condition. A series of tests, including imaging scans and biopsies, usually follows.


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