Malignant Peritoneal Mesothelioma: Facts about the Malignant Peritoneal Mesothelioma

Facts about the Malignant Peritoneal Mesothelioma
Mesothelioma can be benign or malignant. It is divided into four types based on their location: pleural, pericardial, testicular and peritoneal mesothelioma. In this article, we will give you some facts about malignant peritoneal mesothelioma.

What Is It?

To put it simply, it is a type of mesothelioma which forms on the lining of the abdomen. Of all mesothelioma cases, the peritoneal mesothelioma accounts for less than a fifth of the total. The current most effective treatment for this mesothelioma is surgery combined with heated chemotherapy. Immunotherapy is also available as well.

The Cause

The cause of malignant peritoneal mesothelioma is ingesting asbestos fibers. Currently, mesothelioma researchers don’t know how exactly asbestos fibers can reach the abdomen and cause cancer but many theories have been developed.


There are many symptoms of peritoneal mesothelioma. Some of the most common symptoms include:
  • Sudden, unexplained weight loss
  • Fatigue
  • Nausea/vomiting
  • A feeling of fullness
  • Abdominal swelling
  • Abdominal pain
  • Night sweats
  • Fever
  • Anemia
  • Irregular bowel habits
  • Constipation
  • Diarrhea

How It Is Diagnosed

Next, how malignant peritoneal mesothelioma is diagnosed. There are three ways to diagnose peritoneal mesothelioma: blood tests, imaging scans, and biopsies.

Blood Tests
This test is done in order to reveal cancer-related biomarkers

Imaging scans
The scan is done to show the location as well as the size of the tumors

Biopsies are done to know the type of cancerous cells.


Peritoneal mesothelioma is divided into three stages.

Stage 1
In this stage, the cancerous tissue is minimal, cancer doesn’t reach lymph nodes and the tumors are still within the abdominal lining.

Stage 2
In this stage, the cancerous tissue has grown but it is still moderate, the tumors are still inside the abdominal lining.

Stage 3
In this stage, the cancerous tissue has grown extensively, the tumors may have spread outside the abdominal lining, to the lymph nodes or both.


Peritoneal mesothelioma is a neoplasm that originates in the mesothelial cells of the peritoneum. Historically, the survival of patients with malignant peritoneal mesothelioma without treatment is less than 12 months and is considered a chemotherapy resistant neoplasm.

Surgical cytoreduction and regional chemotherapy administered as intraperitoneal hyperthermic chemotherapy ( Hyperthermic Intraperitoneal Chemotherapy , HIPEC) is associated with better long-term survival.

88-year-old woman, whose husband had worked in the automotive industry for more than 30 years (brake specialist), hypertensive. He began a clinical picture eight days before admission with asthenia, adinamia, hyporexia, increased abdominal perimeter, abdominal pain and constipation.

Thoracic radiography showed changes by age and abdominal ultrasound, metastatic liver of unknown primary tumor. Malignant cells compatible with peritoneal malignant mesothelioma were seen in the ascites fluid smear.

The patient died 30 days after diagnosis. Peritoneal mesothelioma is a rare tumor, it can be benign or malignant. The incidence increases with age, is more frequent in men and after 60 years, survival is five to 12 months.

The most important risk factor for developing the disease is chronic exposure to asbestos, which includes indirect contact. It constitutes a neoplasm of difficult diagnosis, even for expert pathologists. Start with data on advanced disease: pain, ascites, weight loss or abdominal mass.

Malignant peritoneal mesothelioma is associated with a long a exposure to asbestos and usually has a poor prognosis. Short survival is due to late diagnosis, as patients are frequently pauci-symptomatic until advanced stage.

Since the tumor is usually confined to the peritoneal cavity, extensive peritonectomy and hypertermic intraoperative intraperitoneal chemotherapy are associated with increased survival in selected patients.

Mesothelioma is an uncommon malignancy that originates from mesothelial cells in serous membranes. Mesothelioma happens mainly in the pleura, but it can happen in the pericardium, tunica vaginalis, in the ovarian epithelium and in the peritoneum.

Although pleural mesothelioma is an asbestos-related disease, our knowledge of peritoneal mesothelioma is limited by its rarity.

Although pleural mesothelioma is a disease with a known relationship with asbestos, knowledge of the natural history of peritoneal mesothelioma is limited by its rarity and late presentation.

Some risk factors for peritoneal mesothelioma include exposure to asbestos, the simian virus, peritoneal irradiation, chronic peritonitis, treatment with thorium dioxide, foreign bodies and infections.

Patients with peritoneal mesothelioma usually present an increase in abdominal volume, ascites, abdominal pain and weight loss, with distension and abdominal pain being the most frequent. In severe cases they can lead to severe pain, intestinal obstruction and weight loss. However, its presentation can be asymptomatic until advanced stages of the disease .

Computed tomography (CT) is the ideal imaging study for the diagnosis of peritoneal mesothelioma. Even when specific findings are not found, the lack of a primary tumor and the absence of lymph nodes or distant metastases can be useful in the difference between peritoneal mesothelioma and other gastrointestinal or gynecological tumors.

In most cases, the diagnosis is made by biopsy obtained by laparotomy or laparoscopy. Macroscopically, peritoneal mesothelioma is characterized by white tumors of varying consistency and size, which can form plaques or masses that cover the peritoneum.

Current strategies for treating this disease include aggressive surgery with chemo and intraoperative and postoperative radiotherapy.