A case of diffuse malignant peritoneal mesothelioma: case report and literature review

Irish Journal of Medical Science 2026 May 19 [Link]

Qian Zhao, Kangwei Xiong, Qiaoyun Wang, Lijiu Zhang

Abstract

Introduction: Diffuse malignant peritoneal mesothelioma (DMPM) is a very rare and life-threateningmalignant tumor.

Case: We present a report of a rare case of a 70-year-old female patient with emaciation and poor appetite as manifestations. The characteristics of signs and clinical manifestations in this case were atypical. Abdominal CT scan revealed a large mass in the right retroperitoneal region beside the inferior vena cava. A neurogenic tumor was considered, and a ganglioneuroma was highly likely. There was no indication of multiple peritoneal implants/seedings in the peritoneum, omentum and liver. Subsequently, an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed. The samples were processed into cell blocks, followed by hematoxylin-eosin (H&E) staining and immunohistochemical staining for observation. The results indicated a possible diagnosis of mesothelioma, while neurogenic tumors were ruled out.

Discussion: During the operation, Multiplenodular tumor lesions were observed between the hepatogastric ligament, on the surface of the liver, in the omentum, and at the splenic hilum, indicating that enhanced CT has certain limitations. If PET-CThad been performed preoperatively, the diagnosis might have been more comprehensive. The diagnosis of DMPM was further verified by laparotomy biopsy. EUS-FNA is a good auxiliary diagnostic method.