Friday, 1 April 2011

Pericardial Mesothelioma, Peritoneal Mesothelioma

It shares epidemiological and pathological features with, but is less common than its pleural counterpart, which is described in detail in the general article on mesothelioma.  Other sub-types (also discussed separately) include :

    * multicystic mesothelioma
    * pericardial mesothelioma

Epidemiology

Approximately 20 - 30% of mesotheliomas arise from the peritoneal serosal lining. As with pleural mesothelioma, there is also a strong association with asbestos exposure, and this occupational hazard probably accounts for disease predominance in middle aged to older males. Despite this, approximately 50% of cases have no history of exposure to asbestos.

Overall incidence is at approximately 1 - 2 cases/million.
Clinical presentation

Typically patients present with weight loss, abdominal pain and/or abdominal distension.

There is a reported correlation between the clinical presentation and CT findings, with subgrouping into 2:

    * “dry-painful” type : presenting with abdominal pain, CT features of peritoneal mass(es) and little to no ascites;
    * “wet” type : presenting with abdominal distension, CT findings of ascites and widespread nodules without a predominant mass and
    * mixed type with both pain and ascites present

Pathology

As with pleural mesothelioma, three histologic sub-types exist :

    * epithelial
    * sarcomatoid and
    * biphasic (mixed epithelial-sarcomatoid)

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