Abstract

APONTE-RUEDA, María Eugenia  and  NIEVES, Maybell. Mesotelioma papilar bien diferenciado. Rev. venez. oncol. [online]. 2009, vol.21, n.4, pp.229-236. ISSN 0798-0582.

INTRODUCTION: The peritoneal mesothelioma is a rare tumour with produce diagnostic and therapeutic problems commonly associated with the asbestos exposure and often considered rapidly fatal. The well differentiated papillary mesothelioma is a less aggressive variety of the tumour, characterized by an indolent course and good prognosis. METHODS: We report the case of a 34 year old man patient who presented clinic with ascitis but without evidence of a portal hypertension, liver disease or any abdominal malignancy. True the procedure diagnostic laparoscopy a small tumour nodule was found to cover the parietal peritoneum and the greater omentum. The imunohistochemestry biopsies practice him were positive for calretinin and cytokeratins. The patient was treated with primary cytostatic therapy. DISCUSION: The progressive ascitis was the only clinical symptom in this patient, while liver disease, portal hypertension and gastrointestinal malignancies were ruled out by clinical, laboratory and the imaging techniques. Laparoscopic biopsy revealed well differentiated papillary mesothelioma to be the underlying disease. Immunocytochemistry is required to establish the diagnosis of this rare malignant disorder which is even more uncommon in men with the absence of a history of the asbestos exposure. CONCLUSION: The peritoneal mesothelioma, although uncommon, should be considered in the people presenting ascitis, in particular in those where the initial diagnosis is not clear.

Keywords : Cancer; tumor; peritoneal; ascitis; mesothelioma; immunohistochemestry.