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Clinical analysis of drypainful type malignant peritoneal mesothelioma

  

  1. Department of Gastroenterology, Cangzhou Central Hospital, Cangzhou  061001, China
  • Online:2017-05-05 Published:2017-05-05
  • Contact: Corresponding author: Guo Qizheng, Email: xhkzgq@sina.com

Abstract: ObjectiveTo retrospectively analyze the clinical characteristics in patients with drypainful type (nonascitic) malignant peritoneal mesothelioma (MPeM). MethodsThe clinical data of 7 cases with drypainful type MPeM were collected during the past 6.5 years, which were confirmed by clinical manifestations, imaging characteristics and pathologic features. The incidence, asbestos exposure history, clinical manifestations, imaging features, pathological types and immunohistochemical results were analyzed respectively. ResultsIn the 7 cases, there were 1 male and 6 female patients which were accounted for 14.3% and 85.7%,respectively.  The average age was 55.5 years old (age range from 28  to 71 years old). There was a definite history of significant asbestos exposure in 6 patients (85.7%). Local abdominal pain (7 cases) and abdominal mass (3 cases) were the main clinical symptoms. CT imaging characteristics: abdominal and/or cavity single (5 cases) or multiple mass (2 cases), accompanied by the surrounding viscera invasion (3 cases), local peritoneal thickening (1 case), pleural plaque (3 cases), without ascites, lymph node enlargement and distant organ metastasis. Laparotomy was the major means of diagnosis, followed by the peritoneal biopsy guided by ultrasound. Epithelial type was the main pthological type (57.1%), followed by mixed and sarcoma type. ConclusionDrypainful type MPeM is extremely rare.and the clinical manifestations are nonspecific. Asbestos exposure history and CT findings with abdominal and/or cavity mass with asbestos plaques and local peritoneal thickening could suggest the possibility of drypainful type MPeM, However, the confirmed diagnosis depends on pathological cytology and immunohistochemistry.

Key words: mesothelioma, pathological type, ascites