Mesothelioma tumors of the peritoneum include benign, malignant and cystic.
Although peritoneal mesothelioma is the most common of these, it is very rare with an annual incidence of 1-2 cases per million persons. Only 10-20 percent of all mesotheliomas arise in the peritoneum. Peritoneal malignant mesothelioma occurs more commonly in adult males but also occurs rarely in children with equal sex incidence.
Malignant mesothelioma occurs mainly late in the fifth decade of life, the benign type in the fourth decade and the cystic type in the third decade. The non malignant type are common in women.
Cause
The link with asbestos exposure which is well established for pleural mesothelioma is not clear for peritoneal mesothelioma.
Symptoms and Signs
-Abdominal pain which may not be limited to any specific region of the abdomen but may be migratory.
-Abdominal distention and complaints associated with partial bowel obstruction are frequent
-Ascites (fluid in the abdomen,) may be present
-Abdominal mass/swelling may be present
Diagnosis
-CT scans frequently show tumor masses and ascites (fluid in the abdomen)
-Laparatomy and laparoscopy for multiple biopsies {the surgeon opens up the abdomen surgically to look into the peritoneum directly and take samples}
Treatment of Peritoneal Mesothelioma
It is treated with combination therapy:
A. Peritoneal radioactive P32 followed by whole abdomen radiation is used often
B. Chemotherapy:Combination chemotherapy with doxorubicin is a very important secondary component.
C. Surgery:Surgical treatment is done mainly to debulk (reduce the size of the tumor by cutting of parts of the tumor,) and treatment of intestinal obstruction.
Prognosis of Peritoneal Mesothelioma
The prognosis of peritoneal mesothelioma is dismal with median survival of about 1 year after presentation. Death usually results from progressive bowel obstruction.
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