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Rare Variants of Malignant Peritoneal Mesothelioma: a Literature Review

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Abstract

Primary peritoneal mesothelioma (PM) is a rare and aggressive malignancy that arises from the peritoneum and classified into diffuse malignant peritoneum mesothelioma (DMPM) and borderline variants, viz. multicystic peritoneal mesothelioma (MCPM) and well-differentiated papillary peritoneal mesothelioma (WDPPM). The borderline variants are rarer than conventional DMPM, are less aggressive form accounting for 3–5% of all cases of peritoneal mesothelioma. In this narrative review article, we have discussed the pathogenesis, clinical presentation, natural history, and management of these rarer variants of PM, viz. MCPM and WDPPM. Histologically, MCPM typically consists of small cysts composed of mesothelial epithelium with benign bland cuboidal cells with clear fluids; cells lack cellular atypia and have increased number of mitoses. WDPPM has specific papillary component with myxoid plump cores and single layer of bland mesothelial cells. Both the variants commonly present as incidental finding or symptoms of chronic abdominal pain, chronic pelvic inflammatory disease, pelvic mass, and infertility. In the absence of treatment, these diseases are slow growing with major concerns being that both the variants have malignant transformation capabilities and a high rate of recurrence. In the light of current evidences, it is recommended that MCPM and WDPPM patients should be offered a complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy consisting of cisplatin and doxorubicin. Collaborative multi-institutional studies are needed to generate more data and formulate robust guidelines.

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References

  1. Moolgavkar SH, Meza R, Turim J (2009 Aug) Pleural and peritoneal mesotheliomas in SEER: age effects and temporal trends, 1973-2005. Cancer Causes Control CCC 20(6):935–944

    Article  PubMed  Google Scholar 

  2. Zhang CH, Yu JW, Luo M (2017) Multicystic peritoneal mesothelioma: a short review. Curr Probl Cancer 41(5):340–348

    Article  PubMed  Google Scholar 

  3. Baratti D, Kusamura S, Nonaka D, Oliva GD, Laterza B, Deraco M (2007) Multicystic and well-differentiated papillary peritoneal mesothelioma treated by surgical cytoreduction and hyperthermic intra-peritoneal chemotherapy (HIPEC). Ann Surg Oncol 14(10):2790–2797

    Article  CAS  PubMed  Google Scholar 

  4. Baratti D, Vaira M, Kusamura S, D’Amico S, Balestra MR, Cioppa T et al (2010) Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Eur J Surg Oncol EJSO 36(11):1047–1053

    Article  CAS  PubMed  Google Scholar 

  5. Kusamura S, Kepenekian V, Villeneuve L, Lurvink RJ, Govaerts K, De Hingh IHJT et al (2021) Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 47(1):36–59

    CAS  Google Scholar 

  6. Kannerstein M, Churg J (1977) Peritoneal mesothelioma. Hum Pathol 8(1):83–94

    Article  CAS  PubMed  Google Scholar 

  7. Attanoos RL, Gibbs AR (1997) Pathology of malignant mesothelioma. Histopathology 30(5):403–418

    Article  CAS  PubMed  Google Scholar 

  8. Weiss SW, Tavassoli FA, Multicystic mesothelioma. (1988) An analysis of pathologic findings and biologic behavior in 37 cases. Am J Surg Pathol 12(10):737–746

    Article  CAS  PubMed  Google Scholar 

  9. Kurisu Y, Tsuji M, Shibayama Y, Yamada T, Ohmichi M (2011) Multicystic mesothelioma caused by endometriosis: 2 case reports and review of the literature. Int J Gynecol Pathol Off J Int Soc Gynecol Pathol 30(2):163–166

    Article  Google Scholar 

  10. Malpica A, Sant’ Ambrogio S, Deavers MT, Silva EG (2012 Jan) Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases. Am J Surg Pathol 36(1):117–127

    Article  PubMed  Google Scholar 

  11. Ross MJ, Welch WR, Scully RE (1989) Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). Cancer 64(6):1336–1346

    Article  CAS  PubMed  Google Scholar 

  12. Churg A, Allen T, Borczuk AC, Cagle PT, Galateau-Sallé F, Hwang H et al (2014) Well-differentiated papillary mesothelioma with invasive foci. Am J Surg Pathol 38(7):990–998

    Article  PubMed  Google Scholar 

  13. Daya D, McCaughey WT (1990) Well-differentiated papillary mesothelioma of the peritoneum. A clinicopathologic study of 22 cases. Cancer 65(2):292–296

    Article  CAS  PubMed  Google Scholar 

  14. Chen X, Sheng W, Wang J (2013) Well-differentiated papillary mesothelioma: a clinicopathological and immunohistochemical study of 18 cases with additional observation. Histopathology 62(5):805–813

    Article  PubMed  Google Scholar 

  15. Lee YK, Jun HJ, Nahm JH, Lim TS, Park JS, Ahn JB et al (2013) Therapeutic strategies for well-differentiated papillary mesothelioma of the peritoneum. Jpn J Clin Oncol 43(10):996–1003

    Article  PubMed  Google Scholar 

  16. Nizri E, Baratti D, Guaglio M, Sinukumar S, Cabras A, Kusamura S, Deraco M (2018) Multicystic mesothelioma: operative and long-term outcomes with cytoreductive surgery and hyperthermic intra peritoneal chemotherapy. Eur J Surg Oncol 44(7):1100–1104

    Article  PubMed  Google Scholar 

  17. Huang Y, Alzahrani NA, Liauw W, Morris DL (2015) Effects of sex hormones on survival of peritoneal mesothelioma. World J Surg Oncol 26(13):210

    Article  Google Scholar 

  18. van Ruth S, Bronkhorst MW, van Coevorden F, Zoetmulder FA (2002) Peritoneal benign cystic mesothelioma: a case report and review of the literature. Eur J Surg Oncol 28(2):192–195

    Article  PubMed  Google Scholar 

  19. Goldblum J, Hart WR (1995) Localized and diffuse mesotheliomas of the genital tract and peritoneum in women. A clinicopathologic study of nineteen true mesothelial neoplasms, other than adenomatoid tumors, multicystic mesotheliomas, and localized fibrous tumors. Am J Surg Pathol 19(10):1124–1137

    Article  CAS  PubMed  Google Scholar 

  20. Torii I, Hashimoto M, Terada T, Kondo N, Fushimi H, Shimazu K et al (2010) Well-differentiated papillary mesothelioma with invasion to the chest wall. Lung Cancer Amst Neth 67(2):244–247

    Article  Google Scholar 

  21. Costanzo L, Scarlata S, Perrone G, Rossi L, Papa A, Di Matteo FM et al (2014) Malignant transformation of well-differentiated papillary mesothelioma 13 years after the diagnosis: a case report. Clin Respir J 8(1):124–129

    Article  PubMed  Google Scholar 

  22. Bürrig KF, Pfitzer P, Hort W (1990) Well-differentiated papillary mesothelioma of the peritoneum: a borderline mesothelioma. Report of two cases and review of literature. Virchows Arch A Pathol Anat Histopathol 417(5):443–447

    Article  PubMed  Google Scholar 

  23. Butnor KJ, Sporn TA, Hammar SP, Roggli VL (2001) Well-differentiated papillary mesothelioma. Am J Surg Pathol 25(10):1304–1309

    Article  CAS  PubMed  Google Scholar 

  24. Gilani SNS, Mehta A, Garcia-Fadrique A, Rowaiye B, Jenei V, Dayal S et al (2018) Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma and predictors of survival. Int J Hyperth 34(5):578–584

    Article  Google Scholar 

  25. Mehta V, Chowdhary V, Sharma R, Golia Pernicka JS (2017) Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature. Clin Imaging 42:133–137

    Article  PubMed  Google Scholar 

  26. Safioleas MC (2006) Benign multicystic peritoneal mesothelioma: a case report and review of the literature. World J Gastroenterol 12(35):5739

    Article  PubMed  PubMed Central  Google Scholar 

  27. Noiret B, Renaud F, Piessen G, Eveno C (2019) Multicystic peritoneal mesothelioma: a systematic review of the literature. Pleura Peritoneum 4(3) https://www.degruyter.com/document/doi/10.1515/pp-2019-0024/html. Accessed 25 Sep 2019

  28. Vicens RA, Patnana M, Le O, Bhosale PR, Sagebiel TL, Menias CO et al (2015) Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists. Abdom Imaging 40(2):436–456

    Article  PubMed  Google Scholar 

  29. Bazine A, Fetohi M, Namad T, Benzekri A, Zainoun B, Tanz R et al (2017) A case of well-differentiated papillary mesothelioma of the male peritoneum: successful treatment by systemic chemotherapy. Cureus 9(3). http://www.cureus.com/articles/6239-a-case-of-well-differentiated-papillary-mesothelioma-of-the-male-peritoneum-successful-treatment-by-systemic-chemotherapy. Accessed 19 Mar 2017

  30. Lee HE, Molina JR, Sukov WR, Roden AC, Yi ES (2018) BAP1 loss is unusual in well-differentiated papillary mesothelioma and may predict development of malignant mesothelioma. Hum Pathol 79:168–176

    Article  CAS  PubMed  Google Scholar 

  31. Sethna K, Mohamed F, Marchettini P, Elias D, Sugarbaker PH (2003) Peritoneal cystic mesothelioma: a case series. Tumori J 89(1):31–35

    Article  Google Scholar 

  32. Chua TC, Yan TD, Deraco M, Glehen O, Moran BJ, Sugarbaker PH (2010) Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma. Br J Surg 98(1):60–64

    Article  PubMed  Google Scholar 

  33. Zahid A, Clarke L, Carr N, Chandrakumaran K, Tzivanakis A, Dayal S et al (2021) Outcomes of multicystic peritoneal mesothelioma treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. BJS Open 5(2):zraa001

    Article  PubMed  Google Scholar 

  34. Yano H, Moran BJ, Cecil TD, Murphy EM (2009) Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal mesothelioma. Eur J Surg Oncol EJSO 35(9):980–985

    Article  CAS  PubMed  Google Scholar 

  35. Brigand C, Monneuse O, Mohamed F, Sayag-Beaujard AC, Isaac S, Gilly FN et al (2006) Peritoneal mesothelioma treated by cytoreductive surgery and intraperitoneal hyperthermic chemotherapy: results of a prospective study. Ann Surg Oncol 13(3):405–412

    Article  CAS  PubMed  Google Scholar 

  36. Kelarji AB, Alshutaihi MS, Ghazal A, Mahli N, Agha S (2021) 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 21(1):374

    Article  PubMed  Google Scholar 

  37. Evangelopoulou EA, Zacharis K, Skoufi G, Vlassis N, Roidoula P, Lialios G (2021) Benign multicystic peritoneal mesothelioma in a postmenopausal woman complicated with an ovarian cyst: a case report. Pan Afr Med J 40:171

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mino JS, Monteiro R, Pigalarga R, Varghese S, Guisto L, Rezac C (2014) Diffuse malignant epithelioid mesothelioma in a background of benign multicystic peritoneal mesothelioma: a case report and review of the literature. BMJ Case Rep 2014:bcr2013200212

    Article  PubMed  PubMed Central  Google Scholar 

  39. Oshikiri H, Ozawa Y, Suzuki O, Usuda M, Miyata G (2022) Benign multicystic peritoneal mesothelioma occurring in bilateral inguinal canals metachronously: a case report. Surg Case Rep 8(1):44

    Article  PubMed  PubMed Central  Google Scholar 

  40. Dzieniecka M, Kałużyński A (2011) Benign multicystic peritoneal mesothelioma (BMPM) - case report and review of the literature. Pol J Pathol Off J Pol Soc Pathol 62(2):122–124

    Google Scholar 

  41. Hamza A, Zazo A, Alrifai MK, Khoja S, Shebli B, Fattal F et al (2021) Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: a rare case report. Ann Med Surg 61:85–87

    Article  Google Scholar 

  42. Luna-Abanto J, Mendoza-Tisoc G, Huanca-Amesquita L, Berrospi-Espinoza F (2020) Benign multicystic peritoneal mesothelioma in a male teen: case report and review of the literature. P R Health Sci J 39(2):222–225

    PubMed  Google Scholar 

  43. Alvir I, Bevanda B, Danolić D, Mamić I, Kostić L, Starčević-Božović A, Puljiz M (2021) Benign multicystic peritoneal mesothelioma mimicking gynecologic pathology. Acta Clin Croat 60(2). https://pubmed.ncbi.nlm.nih.gov/34744286/. Accessed 6 Oct 2017

  44. Jeong JY, Kim SH (2001) Sclerotherapy of peritoneal inclusion cysts: preliminary results in seven patients. Korean J Radiol 2(3):164

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Letterie GS, Yon JL (1998) The antiestrogen tamoxifen in the treatment of recurrent benign cystic mesothelioma. Gynecol Oncol 70(1):131–133

    Article  CAS  PubMed  Google Scholar 

  46. Passot G, Bakrin N, Isaac S, Decullier E, Gilly FN, Glehen O et al (2014) Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies. Eur J Surg Oncol EJSO 40(8):957–962

    Article  CAS  PubMed  Google Scholar 

  47. Arjona-Sanchez A, Rufian-Peña S, Sanchez-Hidalgo JM, Casado-Adam A, Cosano-Alvarez A, Briceño-Delgado J (2018) Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy (HIPEC) by minimally invasive approach, an initial experience. World J Surg 42(10):3120–3124

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Unit of Colorectal and Peritoneal Surface Malignancy, Department of Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, India

    Ambarish Chatterjee

  2. Department of Surgical Oncology, KD Hospital, Ahmedabad, India

    Aditi Bhatt

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  1. Ambarish Chatterjee
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  2. Aditi Bhatt
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Correspondence to Ambarish Chatterjee.

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Chatterjee, A., Bhatt, A. Rare Variants of Malignant Peritoneal Mesothelioma: a Literature Review. Indian J Surg Oncol 14 (Suppl 1), 30–38 (2023). https://doi.org/10.1007/s13193-023-01754-4

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