Peritoneal mesothelioma: an unusual cause of an acute phase response presenting to the rheumatologist

Clinical Rheumatology. 2006 Jan 14;:1-3 [Epub ahead of print]. [Link]

S. S. Hamdulay¹, H. T. Cook², N Strickland³, K. A. Davies⁴ and J. C. Mason¹

(1) Rheumatology Section, Faculty of Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, W12 ONN London, UK
(2) Histopathology Section, Faculty of Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK
(3) Radiology Section, Faculty of Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK
(4) Brighton and Sussex Medical School, University of Sussex, Brighton, UK

Abstract

The presence of an acute phase response may pre-date the eventual diagnosis of malignant disease by months or even years. We describe two patients referred to the rheumatology clinic, in which extensive investigation failed to identify an underlying cause to account for the presenting symptoms and an associated acute phase response. Several months later, repeated abdominal CT scans revealed an abnormality and subsequent laparoscopic biopsy confirmed a diagnosis of peritoneal mesothelioma.

Keywords: Acute phase response – Laparoscopic biopsy – Peritoneal mesothelioma