Mesothelioma as a rapidly developing Giant Abdominal Cyst
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Mesothelioma as a rapidly developing Giant Abdominal Cyst Dinesh Vyas1*, Kerent Pihl2, Srinivas Kavuturu3 and Arpita Vyas4 Abstract The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM). We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium), family history, social (alcohol, smoking) or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.
Case report We describe a healthy and active 58-year-old man, who four months prior to presentation noticed that he was gaining weight, in spite of participating in aerobic exercise daily and having no change in diet. Three months prior to presentation the patient began noticing an increase in abdominal girth, stating that it, ‘felt like a large ball in my belly. The patient began to develop occasional abdominal discomfort, which slowly increased in pain and frequency. The patient also developed symptoms of constipation and severe gastroesophageal reflux, for control of which, he began taking laxatives and a proton pump inhibitor. He eventually saw his primary care physician and had a computer tomography (CT) scan done, showing a large spherical cystic mass in the abdomen measuring 32 cm by 25 cm (Figure 1). The CT scan findings in short were of a massive uniloculated retroperitoneal cyst seen non- communicating to the pleura, or any other abdominal viscera and occupying nearly the entire abdominal space, displacing his entire bowel to the patient’s left, with the cecum and ascending colon located anterior and left of the midline. The mass spanned from the pelvis inferiorly to the liver hilum superiorly. The liver and stomach were compressed. The * Correspondence: [email protected] 1 Department of Surgery, College of Human Medicine, Institute of International Health, Michigan State University, 1200 East Michigan Avenue, Suite 655, Lansing, MI 48912, USA Full list of author information is available at the end of the article
patient was referred to a surgeon and the recommendation was made to proceed with surgery after complete evaluation. He has no risk factors related to the mesothelioma (exposure to asbestos or any virus) or any malignancy. We checked other risk factors including occupational (exposure to silica or cadmium), family history, social (alcohol intake and smoking) or history of trauma. In the operating room, after a midline laparotomy, a massive retroperitonea
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