[Malignant peritoneal mesothelioma: a case report].

I report two cases of malignant peritoneal mesothelioma. Mesothelioma is mostly a pleural disease whether visceral or parietal. Infra-diaphragmatic Mesothelioma accounts for only 10-20% of all mesotheliomas. In over 80% of the cases the pathogenesis is related to asbestos and radiation exposure. However cases with no past history of such exposures appear in the literature. One of our two patients has non past history of exposure to asbestos. In both cases the diagnosis was establishes through both biopsy conducted by laparoscopy and ascites fluid cytology. The disease is most common in males over the age of 40. In case of localised disease cytoreductive surgery using hyperthermic intraperitoneal chemotherapy is recommended. Sadly the disease is often unveiled at an advanced stage requiring palliative chemotherapy usually with a platin derivative or in a small percentage of the cases with abdominal radiotherapy to alleviate pain. Prognosis for patients with malignant peritoneal mesothelioma is very poor with a mean survival of 5,4 months versus 12.5 months for pleural mesothelioma. Peritoneal mesothelioma, although rare, should be considered among the differential diagnosis of ascites differential diagnosis work up.