Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30441. doi: 10.1097/MD.0000000000030441.
Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.
We report a case of a 34-year-old man with solid abdominal cystic echo mass. Physical examination showed that the patient had a flat and soft abdomen without tenderness or rebound pain, no fluid wave tremor, and no obvious abdominal mass was touched. The patient complained of repeated abdominal distention with nausea for 5 days. Sonographic examination suspected pseudomyxoma peritoneum.
Conventional ultrasound examination showed a cystic solid echo mass in the right abdominal cavity of the patient, with uneven internal echo and honeycomb change, and clear boundary with surrounding organs. Color Doppler suggested that the blood flow in the mass was not obvious. Contrast-enhanced computed tomography of the abdomen revealed hypodensity foci in hepatic and renal crypts and right paracolic sulcus.
Laparoscopic resection of the mass was performed, and the postoperative pathological findings were polycystic mesothelioma (greater omentum).
After mass resection, all laboratory tests and abdominal ultrasound were normal, and abdominal distension and nausea disappeared.
Improved ultrasound diagnosis of MM is useful for clinical decision-making.
多房性间皮瘤（MM）非常罕见，术前诊断困难。
我们报告了 1 例 34 岁男性，表现为实性腹部囊性回声肿块。体格检查显示患者腹部平坦柔软，无压痛或反跳痛，无液波震颤，未触及明显腹部肿块。患者诉腹胀、恶心 5 天。超声检查疑诊假性黏液瘤。
常规超声检查显示患者右侧腹腔内有囊性实性回声肿块，内部回声不均匀，呈蜂窝样改变，与周围器官分界清晰。彩色多普勒提示肿块内血流不明显。腹部增强 CT 显示肝、肾隐窝和右结肠旁沟内有低密度灶。
行腹腔镜下肿块切除术，术后病理结果为多囊性间皮瘤（大网膜）。
肿块切除后，所有实验室检查和腹部超声均正常，腹胀和恶心消失。
提高 MM 的超声诊断有助于临床决策。
