Para Ovarian Benign Multicystic Mesothelioma-A Case Report
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 5
Abstract
Mesotheliomas are mesenchymal neoplasms which originate in the lining membrane of various serous cavities and peritoneum. These are benign tumours slow growing. They are incidentally found during laparotomies for ovarian tumours with ascitis. Common in women, exposed to asbestos. We present a rare para ovarian benign multi cystic mesothelioma in a 41-years-old woman who presented like malignant ovarian tumour, with a huge cyst of size 25x15 cm containing four liters of haemorrhagic fluid and four small cysts of size 6x4 cm. Histological picture was confirmative for para ovarian benign mesothelioma. The peritoneum is a mesothelial lining of the abdominal cavity and intra parietal viscera. Mesotheliomas are mesenchymal neoplasms which originate in the lining membrane of various serous cavities, pleural, pericardial and peritoneum. Women present with distension of abdomen, pain, ascites and palpable mass. Most are incidental surgical findings accompanied by multiple cystic peritoneal lesions. Histological picture is predominantly papillary with differentiated mesothelial cells. Often differentiated with adenomatoid tumours and tumours of ovarian epithelium. Peritoneal mesothelioma is a form of mesothelioma that affects the lining of the abdomen often misdiagnosed as ovarian cancer. It is common in asbestos exposed woman. These are slowly progressive. Surgical removal is the treatment. Has high rate or recurrence treated with ant estrogens. A case of para ovarian benign multicystic mesothelioma, who presented as malignant ovarian tumour is presented for its rarity. A 41-years- old P2 L2 sterilized woman reported to the Gynaecology OPD of Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India with the complaint of distension of abdomen, loss of appetite and pain abdomen for three months with regular periods. There was no history of exposure to asbestos. On examination there was a cystic mass of size 34 x 32 cm, occupying the entire abdomen with side to side movement. There was no ascites. Uterus was retroverted and normal in size. Right fornix was occupied by a cystic mass which was extending up to the umbilicus. Tumour marker CA125 was elevated. Ultrasound scan and Computed tomography scan revealed a large cystic mass occupying lower abdomen. Largest cyst was 25 cm x 15 cm with multiple thick septation within the cyst. Multiple small cysts of size 6x4 cm were also seen on right ovary. A diagnosis of malignant right ovarian tumour was made. The patient underwent staging laparotomy. Uterus was normal in size. Left tube and ovary were normal. Right side-tube had fimbrial cyst 5x4 cm with haemorrhagic fluid. A multiloculated right ovarian cyst, largest measuring 25x15 cm filled with haemorrhagic fluid about four liters, and four smaller cysts of size 6 cmx4 cm were present. Same removed with ovary. There was no papillary projection or solid areas. Minimal clear peritoneal fluid staging was 0 as tumour was benign. Uterus cervix and right diseased ovary with multilocilated cysts and the normal left ovary was also removed with tubes, abdomen explored, left ovary was removed because we don’t have any facility for frozen section of the normal ovary. Omental biopsy taken and abdomen closed in layers. Uterus cervix both tubes left normal ovary right ovary with multiple cysts were send for histopathalogical examination. HPE REPORT - a diagnosis of Para ovarian multi cystic mesothelioma was made. The Omentum also showed mesothelial proliferation. Her postoperative period was uneventful and the patient was discharged on the 10th day patients was followed after 3 months, 6months and 1 year, patient is healthy and leading a normal life.
Authors and Affiliations
Wills G Sheelaa, A Gowri Bai
Keywords
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- EP ID EP581085
- DOI 10.26717/BJSTR.2017.01.000458
- Views 194
- Downloads 0
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