Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up

“Omental Cake” in a Patient With Asbestosis Leading to the Diagnosis of Malignant Peritoneal Mesothelioma

“…Other mineral fibers likely play a causative role, with the silicate fiber erionite also being a potent inducer of MPM. In addition, other factors described include therapeutic radiation, papovirus, simian virus, chronic inflammation, and inherited susceptibility [1][2][3].…”

“…However, definitive diagnosis is by biopsy, which can be guided by radiology (CT) or surgery. MPM includes three histologic subtypes: epithelioid (as seen in our case), sarcomatous, and biphasic [1][2][3][4][5][6][7]. There is no uniformly accepted classification system for MPM.…”

“…Other pathologies such as peritoneal carcinomatosis secondary to gastrointestinal or ovarian neoplasm, as well as peritoneal tuberculosis, must be dismissed [1][2][3].…”

“…The selection of the best therapeutic management should be done by a multidisciplinary team specialized in this type of neoplasm, with the current therapeutic options being both cytoreductive surgery with intraperitoneal hyperthermic chemotherapy or systemic chemotherapy [1][2][3][4]9]. The patients who benefit from this first, more aggressive therapy are those with good performance status (defined as Eastern Cooperative Oncology Group score 0 or 1), disease distribution favorable for complete or near-complete cytoreductive surgery (extension and depth of the tumor disease does not affect beyond the mesothelial surface), epithelioid histology, female sex (female patients survive longer than male patients), age <60 years, and absence of pretreatment thrombocytosis [1][2][3][4][9][10][11]. However, for those patients who do not meet these characteristics or whose condition is not operable, systemic chemotherapy (cisplatin and pemetrexed) must be considered, although the disease is usually refractory to the usual regimens [1][2][3][4]9].…”

“…Malignant peritoneal mesothelioma (MPM) is a rare neoplasm that accounts for 10%-15% of all mesothelioma cases and it is associated up to 50% of the time with asbestosis. It usually presents without differences in terms of sex, with a mean age of 64 years and related to the intra-abdominal locoregional effect, insidiously in the form of abdominal pain or distension [1][2][3][4].…”