Benign multicystic peritoneal mesothelioma in a patient with acute appendicitis. A clinical case

The benign form of mesothelioma is an extremely rare occurrence among women and even rarer among males. This pathology is often asymptomatic, making differential diagnosis difficult. Currently, there is no standardized prevention and treatment of patients with this pathology. The recurrence rate is about half of the cases. Purpose. The purpose of this work is to present a rare case of benign multicystic peritoneal mesothelioma in a patient who was admitted to hospital with suspected acute appendicitis. Materials and methods. Patient B., 32 years old, BMI = 23.6 kg/m2, complained of pain in the right iliac region and nausea; symptoms of peritoneal irritation were negative, while appendicular symptoms were positive; the ultrasound showed free fluid in the pelvis and iliac regions; according to CT, there were signs of thickening of fiber, due to what the preliminary diagnosis of acute appendicitis was made. During the surgery, laparoscopic appendectomy and abdominal drainage were performed. Results. Intraoperatively, a cystic (mucinous) formation on a pedicle measuring 2.5x1.0 cm was detected in the mesentery of the cecum. Similar mucinous formations of various sizes lay freely in the pelvis. There were no intraoperative complications. Intraoperative diagnosis: acute phlegmonous appendicitis; cystic (mucinous) formation in the mesentery of the cecum. A histological examination revealed a diagnosis of benign multicystic mesothelioma (a multinodular peritoneal inclusion cyst). Acute superficial appendicitis. The postoperative period was uneventful. Conclusion. The clinical case under consideration draws attention to the need for differential diagnostics between diseases of the abdominal cavity and pelvic organs and benign multicystic peritoneal mesothelioma, as well as the necessity to prevent undesirable consequences at the preoperative and postoperative stages.