Benign multicystic mesothelioma with ovarian endometriosis: a rare case report with review of literature

Basanta Manjari Hota, Kavitha Bakshi, Naimisha Movva, Swathi Pandirla
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2022 · vol. 11(11) , pp. 3209 · doi:10.18203/2320-1770.ijrcog20222823 · W4307809915
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This case report describes a 33-year-old woman diagnosed with benign multicystic mesothelioma concurrent with ovarian endometriosis, highlighting the condition's rarity and potential for recurrence.

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This case report describes a 33-year-old woman presenting with chronic abdominal pain and a right adnexal multiloculated cystic mass, initially suspected to be an ovarian cyst. Surgical excision via laparotomy revealed the diagnosis of benign multicystic mesothelioma co-occurring with ovarian endometriosis. The authors highlight the rarity of this presentation and emphasize the potential for local recurrence and malignant transformation, necessitating long-term patient follow-up after complete surgical removal. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up.
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Benign multicystic mesothelioma with ovarian endometriosis: a rare case report with review of literature DOI: https://doi.org/10.18203/2320-1770.ijrcog20222823Keywords: Mesothelioma, Benign, Endometriosis, Neoplastic, ReactiveAbstract Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up. Metrics References Safioleas MC, Constantinos K, Michael S, Konstantinos G, Constantinos S, Alkiviadis K. Benign multicystic peritoneal mesothelioma: a case report and review of the literature. World J Gastroenterol. 2006;12(35):5739-42. Noiret B, Renaud F, Piessen G, Eveno C. Multicystic peritoneal mesothelioma: a systematic review of the literature. Pleura Peritoneum. 2019;4(3):20190024. Kelarji AB, Alshutaihi MS, Ghazal A, Mahli N, Agha S. A rare case of benign multicystic peritoneal mesothelioma misdiagnosed as hydatid cyst found in the liver parenchyma and abdomen cavity of a male with asbestos exposure. BMC Gastroenterol. 2021;21(1):374. Levy AD, Arnáiz J, Shaw JC, Sobin LH. Primary peritoneal tumors: imaging features with pathologic correlation. Radiographics 2008;28(2):583-607. Vyas D, Pihl K, Kavuturu S, Vyas A. Mesothelioma as a rapidly developing giant abdominal cyst. World J Surg Oncol. 2012;10:277. Khurram MS, Shaikh H, Khan U, Edens J, Ibrar W, Hamza A, et al. Benign multicystic peritoneal mesothelioma: a rare condition in an uncommon gender. Case Rep Pathol. 2017;2017:9752908. Bhandarkar DS, Smith VJ, Evans DA, Taylor TV. Benign cystic peritoneal mesothelioma. J Clin Pathol. 1993;46(9):867-8. Pitta X, Andreadis E, Ekonomou A, Papachristodoulou A, Tziouvaras C, Papapaulou L, et al. Benign multicystic peritoneal mesothelioma: a case report. J Med Case Rep. 2010;4:385. Yang DM, Jung DH, Kim H, Kang JH, Kim SH, Kim JH, et al. Retroperitoneal cystic masses: CT, clinical, and pathologic findings and literature review. Radiographics. 2004;24(5):1353-65. Letterie GS, Yon JL. The antiestrogen tamoxifen in the treatment of recurrent benign cystic mesothelioma. Gynecol Oncol. 1998;70(1):131-3. Letterie GS, Yon JL. Use of a long-acting GnRH agonist for benign cystic mesothelioma. Obstet Gynecol. 1995;85:901-3.

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