Benign Multicystic Peritoneal Mesothelioma Mimicking Acute Appendicitis: A Case Report

Background: Benign multicystic peritoneal mesothelioma is a rare tumor derived from mesothelial cells characterized by multiple thin-walled cysts attached to the peritoneal surfaces. It occurs more frequently in women and has been associated with previous abdominal surgery, endometriosis, or pelvic inflammatory disease. Despite its benign nature, it has a high recurrence rate after surgical treatment.Case presentation: We report the case of a 34-year-old male with a history of bilateral varicocelectomy and bilateral inguinal hernioplasty who presented to the emergency department with acute onset right lower quadrant abdominal pain suggestive of acute appendicitis. Laboratory tests showed elevated C-reactive protein levels. Abdominal computed tomography revealed multiple well-defined cystic lesions in the right lower abdomen and pelvis. Diagnostic laparoscopy was performed due to suspicion of a periappendiceal abscess, revealing a 6 × 4 × 2 cm multicystic tumor attached to the mesentery and right colon, along with multiple grape-like cystic lesions throughout the abdominal cavity. Local tumor resection, removal of most cystic lesions, and appendectomy were performed. Histopathological examination confirmed the diagnosis of benign multicystic peritoneal mesothelioma.Conclusion: This case highlights an uncommon presentation of benign multicystic peritoneal mesothelioma in a male patient mimicking acute appendicitis. Laparoscopy plays an important role in both diagnosis and treatment, allowing complete surgical resection. Long-term follow-up is recommended due to the risk of recurrence. Article Details This work is licensed under a Creative Commons Attribution 4.0 International License.

I. González Vitores AM, Garzo Pipo ML, Pujadas Morató M, Muñoz Collado S, Moreno Amezcua J. Mesotelioma peritoneal quístico benigno. Presentación de un caso. Servicio de Cirugía General y de Aparato Digestivo, Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona. II. Occhionorelli, S., Tartarini, D., Pascale, G., Maccatrozzo, S., Stano, R., & Vasquez, G. (2016). Benign multicystic mesothelioma of peritoneum complicating acute appendicitis in a man: a case report. Journal of Medical Case Reports, 10(1). https://doi.org/10.1186/s13256-016-0826-6 III. Fernández, R. L. G., Fernández-González, M. V., López‐Rodríguez, A., & Fernández, R. M. (2016). Mesotelioma multiquístico peritoneal benigno recidivante: abordaje de esta entidad tan poco frecuente. Cirugia Y Cirujanos, 84(6), 499–502. https://doi.org/10.1016/j.circir.2015.08.013 IV. Limone A, Maier J, Chiantera V, Elezkurtaj S, Foss HD, Schneider A. Laparoscopic excision of a benign peritoneal cystic mesothelioma. Arch Gynecol Obstet. 2010 Mar;281(3):577-8. doi: 10.1007/s00404-009-1203-0. Epub 2009 Aug 11. PMID: 19669775. V. van Ruth S, Bronkhorst MW, van Coevorden F, Zoetmulder FA. Peritoneal benign cystic mesothelioma: a case report and review of the literature. Eur J Surg Oncol. 2002 Mar;28(2):192-5. doi: 10.1053/ejso.2000.1215. PMID: 11884057. VI. Witek TD, Marchese JW, Farrell TJ. A recurrence of benign multicystic peritoneal mesothelioma treated through laparoscopic excision: a case report and review of the literature. Surg Laparosc Endosc Percutan Tech. 2014 Apr;24(2):e70-3. doi: 10.1097/SLE.0b013e31828f7269. PMID: 24686367. VII. Morales Artero S, Castellón Pavón CJ, Larraz Mora E, de Jaime Guijarro JM, García Vásquez C, Calvo Serrano M. Laparoscopic treatment of retroperitoneal cystic mesothelioma. Two cases reported. Int J Surg Case Rep. 2016;29:230-233. doi: 10.1016/j.ijscr.2016.10.043. Epub 2016 Nov 17. PMID: 27918979; PMCID: PMC5144751. VIII. Segura Martín M, Lorenzo Romero JG, Hernández Millán I, Pastor Guzmán JM, Salinas Sánchez AS, Ruiz Mondéjar R, Virseda Rodríguez JA. Mesotelioma y linfangioma quísticos retroperitoneales [Retroperitoneal cystic mesothelioma and lymphangioma]. Actas Urol Esp. 1998 Mar;22(3):253-6. Spanish. PMID: 9616937. IX. Canu GL, Medas F, Columbano G, Gordini L, Saba L, Erdas E, Calò PG. Benign Multicystic Peritoneal Mesothelioma in a Male Patient with Previous Wilms' Tumor: A Case Report and Review of the Literature. Case Rep Surg. 2018 Aug 1;2018:4324986. doi: 10.1155/2018/4324986. PMID: 30155337; PMCID: PMC6093066. X. Ricci F, Borzellino G, Ghimenton C, Cordiano C. Benign cystic mesothelioma in a male patient: surgical treatment by the laparoscopic route. Surg Laparosc Endosc. 1995 Apr;5(2):157-60. PMID: 7773468.