An overview of peritoneal mesothelioma
Peritoneal mesothelioma for the primary and peritoneal mesothelium cell tumor of the organization, clinical rare. Pathology can be divided into adenomatoid mesothelioma , cystic mesothelioma and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma was particularly prevalent in women, the cause is unknown, occurred in the surrounding pelvic or annex, was single or multiple cystic masses; patients often palpable abdominal mass and treatment. PMM account for about 30% of malignant mesothelioma; its occurrence and also closely related to asbestos exposure, about 5% of the patients have a history of exposure ; asbestos fiber intake by mouth, through the intestinal wall and translocation to the peritoneal disease . Exposure to asbestos from the diagnosis, the disease incubation period of up to 25 to 40 years. However, from 1951 to 1993, domestic 20 reported 161 cases of PMM in only 1 case has a history of exposure to asbestos. No history of exposure to asbestos in the crowd, the incidence of about 1 / 1 million years, may be related to certain infections and genetic factors [2, 3, 4]. Foreign PMM reported 1 case of a patient more than 40 years ago have come into contact with glial thorium dioxide (Thorotrast) . PMM often occurred in men over the age of 40. Visceral or parietal peritoneum and the incidence may be; direct violation of abdominal tumor, pelvic organs; 50% to 70% of patients with lymphoid and (or) distant metastasis, such as liver, kidney, adrenal gland, lung, bone and lymph nodes, etc. . This lack of specificity of clinical disease, abdominal pain, constipation, bloating, weight loss and other performance obstruction . Physical examination can be found ascites or abdominal mass, and so on. For ascites effusion, as part of the blood. This disease misdiagnosed as tuberculosis peritonitis, recurrent spontaneous peritonitis, inflammation of superior mesenteric or peritoneal metastases, and so on. Ascites hyaluronic acid increased significantly,> 0.8g / L were only found in the PMM. Ascites exfoliated cells are of the value of the check, but often difficult to judge. Serum carbohydrate antigen -125 (CA125) increased to help diagnose this disease [6,7]. CT and ultra-performance of the B variety, are typically irregular thickening of the peritoneum, omentum adhesion was Pie, was superior mesenteric tissue samples; CT can also enhance the display of pancreatic mass-week-or intra-abdominal diffuse large mass substantive And violations of the intestine and mesenteric; or peritoneal nodules, or cystic mass was; more with varying degrees of ascites . Ultrasound or CT-guided biopsy a certain value. PMM diagnostic laparoscopy is a simple and effective method of peritoneal microscope, the retina diffuse plaques and nodules, and biopsy pathology under direct examination. We have given 1 case of 83-year-old male patient, laparoscopy, peritoneal biopsy report of the mesothelial cells, after the Organization immune to chemical and biological inspection confirmed PMM. Butchart, and other PMM will be divided into 4: I, confined to the peritoneal tumor; Ⅱ period, intra-abdominal lymph node tumor; Ⅲ, tumor metastasis to the lymph nodes outside the abdominal cavity; Ⅳ, distant metastasis. The above categories will help to choose treatment. PMM so far no effective standard treatment. Very poor prognosis, the survival period after diagnosis with a median of 1 year, 2-year survival than those less than 20%. The main cachexia or died of intestinal obstruction, and rarely the cause of death related to tumor metastasis.