Peritoneal Mesothelioma Introduction

Peritoneal mesothelioma in the primary peritoneal mesothelial organizations and epithelial tumors, clinical rarely see.

Disease Arguments can be divided into adenomatous mesothelioma,cystic mesothelioma and peritoneal malignant mesothelioma(PMM).

The first two are benign. Cystic mesothelioma was particularly prevalent in women, Cause unknown, occurred in the surrounding pelvic or attachments, a single or multiple cystic masses; patients often palpable abdominal mass and attendance. PMM about vicious Mesothelioma of 30%; in its close relationship with exposure to asbestos, about 5% of the patients have a history of exposure ; asbestos fibers after oral intake through Translocation to the wall and peritoneal disease. Exposure to asbestos from confirmed, the disease incubation period could be as long as 25 to 40 years. But from 1951 to 1993 domestic 20 reported 161 cases of the literature only one case of PMM a history of exposure to asbestos. In the absence of a history of exposure to asbestos in the crowd, the incidence rate of about 1 / 1 million years, Infection may be related to certain genetic factors. Reported one case of international, PMM patients more than 40 years ago dioxide contacts glial Thorium (Thorotrast) .

PMM often occur in men over 40 years of age. Dirty floor or layer can be permanently and peritoneal tumor can be a direct violation of abdominal, pelvic Organ, 50% to 70% of the patients with lymph node and (or) blood distant metastasis such as liver, kidney, adrenal gland, lung, bone and lymph nodes, etc..

Clinical manifestations of this disease Lack of specificity, have abdominal pain, constipation, abdominal distension, weight loss and other intestinal obstruction performance. Physical or ascites can be found, such as abdominal mass. Ascites To exudate, some bloody. The disease often misdiagnosed as tuberculosis peritonitis and recurrent spontaneous bacterial peritonitis, mesenteric inflammation or peritoneal carcinomatosis Etc..

Ascites hyaluronic acid increased significantly,> 0.8 g / L found only PMM. Ascites exfoliated cells also check some value, but the result often difficult Judgement. -125 Serum carbohydrate antigen (CA125) increased help diagnose this disease.

B-ultrasound and CT performance varied, the typical irregular, peritoneal Thickening and omental adhesion was popular among hungry students, mesenteric a tissue sample; CT can also display enhanced Peripancreatic large mass, or intraperitoneal substantive diffuse large Mass, and bowel and mesenteric violations or peritoneal nodules, or a cystic mass, multi-with varying degrees of ascites.

Guided by ultrasound or CT wear Thorn biopsy a certain value. PMM diagnostic laparoscopy is a simple and effective method microscope peritoneum, omentum diffuse plaques and nodules, Open biopsy and pathological examination. We sent one case of 83-year-old male patient with laparoscopy, peritoneal biopsy report mesothelial cell hyperplasia, After immunohistochemical tests confirmed the PMM. Butchart, and so will be divided into four PMM: Phase I, confined to the peritoneal tumor; Ⅱ stage, tumor invasion Intra-abdominal lymph nodes; Ⅲ, tumor metastasis to the lymph nodes outside the abdominal cavity; Ⅳ period, blood distant metastasis. The above categories will help choose the method of treatment.

PMM has no effective standard treatment. Poor prognosis, the survival period after diagnosis in a median survival of more than two years of less than 20%. Main Dioxin or died of intestinal obstruction of the death of little distant metastasis and tumor.

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