Aims: Very few cases of diffuse, malignant, peritoneal mesothelioma have been reported in young women. Distinction between peritoneal mesothelioma and serous epithelial tumours, including papillary serous carcinomas and borderline serous tumours, can be difficult. Differential diagnosis based on clinical appearance and imaging techniques is broad and inconclusive, thus the diagnosis must be confirmed by histological examination. Because the vast majority of tumours involving the peritoneal and serosal surfaces are due to primary or metastatic serous epithelial tumours, there is a tendency on the part of pathologists to disregard the possibility of mesothelioma when examining a biopsy or excision specimen. This is especially likely to occur when mesothelioma is associated with highly elevated serum levels of CA‐125, which is the typical tumoral marker of epithelial serous tumours from the ovary. The association between peritoneal mesothelioma and high serum levels of CA‐125 has been reported in the literature only in two cases. Case details: In order to avoid a misdiagnosis of this neoplasm we describe a new case of peritoneal mesothelioma in an 18‐year‐old woman with high serum levels of CA‐125. Conclusions: Besides its clinicopathological characteristics and its histological, immunohistochemical and ultrastructural features, we describe its biological behaviour, which seems to be worst when CA‐125 levels are high.

BackgroundPegylated Interferon-alpha-2b (pegIFNα2b) is an effective agent for the treatment of haematological malignancies. As it does not inhibit DNA synthesis, this agent may be safe for use during pregnancy.PurposeTo describe 2 cases of successful pregnancies in patients with haematological disorders treated with pegIFNα2b.Material and methodsMedical record review and literature search.ResultsPatient 1: 30-year-old woman diagnosed with polycythaemia vera at age 13, well-controlled with hydroxyurea. Chemotherapy was interrupted due to the patient’s desire for a second pregnancy and treatment with pegIFNα2b 50mcg/week subcutaneously was initiated. (During the first pregnancy she received non-pegylated-IFNα2b with good progression but low tolerance due to influenza-like symptoms). 5 months later, she became pregnant, but was hospitalised due to headaches which caused a dose reduction to 30 mcg/week of pegIFNα2b. Finally, the patient delivered a healthy male infant. 15 days later, pegIFNα2b treatment was interrupted to recommence the usual treatment with hydroxyurea.Patient 2: 27-year-old woman with Philadelphia chromosome-positive chronic myeloid leukaemia diagnosed at age 22, well-controlled with imatinib. The patient interrupted antineoplastic treatment due to her desire to conceive a child and subcutaneous treatment with pegIFNα2b at 50 mcg/week was initiated. She became pregnant after 4 months and pegIFNα2b dose was increased to 80 mcg/week and developed hypothyroidism which was treated with levothyroxine. Finally, the patient delivered a healthy male infant and 1 month later, she discontinued pegIFNα2b and levothyroxine treatment to recommence her usual treatment with imatinib.Both were normal full-term deliveries. Infant growth and development have been normal to date (follow-up time of 2 and 3 years). Blood tests were normal during pregnancies. Only mild anaemia and slight neutrophilia were detected in the first patient, but did not require treatment interruption.ConclusionPegIFNα2b was well tolerated, safe and effective, and caused no complications during the pregnancies. Since chemotherapy agents involve teratogenic effects, pegIFNα2b might be a safe treatment option during pregnancy, although further teratogenic studies are necessary.References and/or acknowledgementsNo conflict of interest.

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We report the results of treatment with MACOP-B in 11 young patients with low grade lymphoma (LGL). Complete remission was obtained in 4 (57%) and partial remission in 3 (42.8%) of 7 evaluable patients. However, this aggressive chemotherapy has not offered any advantage because of an unacceptably high treatment-related morbidity and mortality (17%). Serious infection during neutropenia was the most common complication.

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