Patel Kruti K, Stinson Griffin P, Terracina Krista P, Nordenstam Johan F, Read Thomas E
Division of Gastrointestinal Surgery, University of Florida College of Medicine, 1600 SW Archer Road, Rm 6165, PO Box 100109, Gainesville, FL 32601, United States.
J Surg Case Rep. 2024 Sep 5;2024(9):rjae569. doi: 10.1093/jscr/rjae569. eCollection 2024 Sep.
Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, in which patients have multiple cystic lesions of the peritoneum. BMPM can mimic mucinous carcinomatosis and can thus create a diagnostic dilemma. We present the case of a 76-year-old woman who was referred for management of ascending colon adenocarcinoma and was noted to have several nonspecific cystic lesions in the abdomen and pelvis on preoperative computed tomography and diagnostic laparoscopy. Frozen section analysis suggested the lesions contained 'mucin'. Due to concern for metastases, right colectomy was aborted. Final histologic analysis of the laparoscopic biopsies revealed mesothelial cysts, consistent with BMPM, unrelated to her colon adenocarcinoma. Laparoscopic right colectomy was performed 2 weeks later. BMPM can create diagnostic and therapeutic uncertainty in patients with known visceral malignancies when discovered incidentally. Frozen section analysis may not be accurate in differentiating the two, and final histologic confirmation should be sought prior to definitive treatment.
良性多囊性腹膜间皮瘤（BMPM）是一种罕见疾病，患者腹膜有多个囊性病变。BMPM可酷似黏液性癌病，从而造成诊断上的两难局面。我们报告一例76岁女性病例，该患者因升结肠癌前来就诊，术前计算机断层扫描和诊断性腹腔镜检查发现其腹部和盆腔有多个非特异性囊性病变。冰冻切片分析提示病变含有“黏液”。由于担心转移，右半结肠切除术中止。腹腔镜活检的最终组织学分析显示为间皮囊肿，符合BMPM，与她的结肠腺癌无关。两周后进行了腹腔镜右半结肠切除术。偶然发现BMPM时，对于已知内脏恶性肿瘤患者可造成诊断和治疗上的不确定性。冰冻切片分析在鉴别这两者时可能不准确，在进行确定性治疗前应寻求最终组织学确诊。
