Malignant Peritoneal Mesothelioma Revealed by Progressive Abdominal Distension: A Case Report

Abstract

Introduction: Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer arising from mesothelial cells lining the peritoneal cavity. Case presentation: We report the case of a 52-year-old man with no history of asbestos exposure, who presented with progressive, painless abdominal distension. Imaging and laparoscopy revealed massive ascites and peritoneal granulations. Cytology showed atypical cells, and histo-immunohistochemistry confirmed epithelioid peritoneal mesothelioma. The patient underwent cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin. Ascites remained minimal and stable over a two-year follow-up. Discussion: MPM is a rare neoplasm arising from the serosal lining of the peritoneum. It typically affects men between the ages of 47 and 60.5. The disease is often asymptomatic or presents with nonspecific symptoms such as abdominal distension and pain, leading to diagnosis at intermediate or advanced stages. Tumor biopsy and immunohistochemistry are essential for diagnosis. Cytoreductive surgery combined with HIPEC currently represents the cornerstone of treatment. Conclusion: MPM is a rare malignancy with a controversial association with asbestos exposure. Diagnosis relies on morphological and immunohistochemical features. Optimal management requires a multidisciplinary approach.