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Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report

BACKGROUND: Malignant peritoneal mesothelioma (MPM) is an extremely rare tumor with nonspecific clinical manifestations, which is extremely difficult to diagnose. Herein, we reported a case of MPM in the abdominal cavity with massive short-term ascites as the first symptom. CASE SUMMARY: A 65-year-o...

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Autores principales: Huang, Xi, Hong, Yu, Xie, Si-Ya, Liao, Hui-Li, Huang, Hao-Ming, Liu, Jian-Hong, Long, Wen-Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561583/
https://www.ncbi.nlm.nih.gov/pubmed/36246798
http://dx.doi.org/10.12998/wjcc.v10.i28.10317
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author Huang, Xi
Hong, Yu
Xie, Si-Ya
Liao, Hui-Li
Huang, Hao-Ming
Liu, Jian-Hong
Long, Wen-Jie
author_facet Huang, Xi
Hong, Yu
Xie, Si-Ya
Liao, Hui-Li
Huang, Hao-Ming
Liu, Jian-Hong
Long, Wen-Jie
author_sort Huang, Xi
collection PubMed
description BACKGROUND: Malignant peritoneal mesothelioma (MPM) is an extremely rare tumor with nonspecific clinical manifestations, which is extremely difficult to diagnose. Herein, we reported a case of MPM in the abdominal cavity with massive short-term ascites as the first symptom. CASE SUMMARY: A 65-year-old woman presented to the hospital with abdominal pain, distention, and shortness of breath that persisted for 15 d. The serum CA-125 level was 1075 U/mL. The abdominal computed tomography showed massive ascites and no obvious tumor lesions. The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures. The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2 (-), WT-1 (-), Ki-67 (about 10% +), CEA (-), Glut-1 (+++), desmin (-), PD-L1 (-), and CDKN2A (P16). The final diagnosis was MPM. The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy. In the second cycle, she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites. She died of disease progression 2 mo after diagnosis. CONCLUSION: In case of massive unexplained ascites, the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment.
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spelling pubmed-95615832022-10-15 Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report Huang, Xi Hong, Yu Xie, Si-Ya Liao, Hui-Li Huang, Hao-Ming Liu, Jian-Hong Long, Wen-Jie World J Clin Cases Case Report BACKGROUND: Malignant peritoneal mesothelioma (MPM) is an extremely rare tumor with nonspecific clinical manifestations, which is extremely difficult to diagnose. Herein, we reported a case of MPM in the abdominal cavity with massive short-term ascites as the first symptom. CASE SUMMARY: A 65-year-old woman presented to the hospital with abdominal pain, distention, and shortness of breath that persisted for 15 d. The serum CA-125 level was 1075 U/mL. The abdominal computed tomography showed massive ascites and no obvious tumor lesions. The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures. The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2 (-), WT-1 (-), Ki-67 (about 10% +), CEA (-), Glut-1 (+++), desmin (-), PD-L1 (-), and CDKN2A (P16). The final diagnosis was MPM. The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy. In the second cycle, she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites. She died of disease progression 2 mo after diagnosis. CONCLUSION: In case of massive unexplained ascites, the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment. Baishideng Publishing Group Inc 2022-10-06 2022-10-06 /pmc/articles/PMC9561583/ /pubmed/36246798 http://dx.doi.org/10.12998/wjcc.v10.i28.10317 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Huang, Xi
Hong, Yu
Xie, Si-Ya
Liao, Hui-Li
Huang, Hao-Ming
Liu, Jian-Hong
Long, Wen-Jie
Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report
title Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report
title_full Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report
title_fullStr Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report
title_full_unstemmed Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report
title_short Malignant peritoneal mesothelioma with massive ascites as the first symptom: A case report
title_sort malignant peritoneal mesothelioma with massive ascites as the first symptom: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561583/
https://www.ncbi.nlm.nih.gov/pubmed/36246798
http://dx.doi.org/10.12998/wjcc.v10.i28.10317
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