Thrombocytosis as a paraneoplastic syndrome in metastatic malignant peritoneal mesothelioma of biphasic morphology mimicking ovarian adenocarcinoma: A case report

Abstract

Malignant peritoneal mesothelioma (MPM) is a rare malignancy, presenting with non‐specific and potentially‐misleading manifestations. It represents a diagnostic pitfall as it mimics ovarian carcinoma. Maintaining a low diagnostic threshold, obtaining a detailed history, and utilizing immunohistochemical markers to diagnose MPM is crucial as early diagnosis and treatment might improve survival.

Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome

“…In the past, MPM with PS was considered rare and was often reported as an atypical manifestation of the primary tumor. Specific manifestations can involve multiple organ systems: (1) Hematologic system: thrombocytosis [ 12 ], autoimmune hemolytic anemia [ 13 ], malignant tumor-associated thrombosis [ 14 ], leukemoid reaction [ 15 ], recurrent thrombotic thrombocytopenic purpura like syndrome [ 16 ]; (2) Endocrine system: hypoglycemia [ 17 ] and ectopic corticotrophin secretion syndrome [ 18 ]; (3) Urinary system: nephrotic syndrome [ 19 ]; (4) Nervous system: myasthenia gravis [ 20 ]; (5) Rheumatic system: antiphospholipid syndrome [ 21 ] and polymusdoid rheumatism syndrome [ 22 ]; (6) Cutaneous system: dermatomyositis [ 23 ]; (7) Others: neoplastic fever [ 24 ] and cachexia.…”

“…The possible mechanism of MPM-related thrombocytosis is that mesothelioma cells persistently secrete interleukin-6, which stimulate thrombopoietin to induce thrombocytosis [ 25 ]. Alhamadh et al [ 12 ] pointed out that thrombocytosis is a surrogate marker for tumor aggressiveness and has been associated with poor survival. The second most common PS was neoplastic fever (9.6%).…”