Advertisements

Peritoneal mesothelioma is a malignant tumor originating from the mesothelial cells of the serous lining of the abdominal cavity. Clinically, peritoneal mesothelioma is manifested by abdominal pain, nausea, vomiting, weight loss, ascites. Diagnosis of mesothelioma is based on data from ultrasound and MSCT of the abdominal cavity; The decisive diagnostic criterion is the detection of atypical cells in ascitic fluid or biopsy obtained during diagnostic laparoscopy. Peritoneal mesothelioma can be treated with surgery, radiation therapy, or chemotherapy. The prognosis for mesothelioma is unfavorable.

  • Causes and forms of peritoneal mesothelioma
  • Symptoms of peritoneal mesothelioma
  • Diagnosis of peritoneal mesothelioma
  • Treatment of peritoneal mesothelioma
  • Prevention and prognosis for peritoneal mesothelioma
  • Prices for treatment

Mesothelioma of the peritoneum

General information

Mesothelioma ( endothelioma , carcinosarcoma) is a primary tumor growing from mesothelial cells present in the serous membranes that line body cavities. Depending on the localization, peritoneal mesothelioma, pleural mesothelioma , less often – pericardial mesothelioma are distinguished . Among tumors of this type, peritoneal mesothelioma accounts for 10-20% of cases. Peritoneal mesothelioma develops mainly in men over 40 years of age.

Causes and forms of peritoneal mesothelioma

It is believed that the development of peritoneal mesothelioma and other localizations is directly related to prolonged and intense human contact with asbestos. Asbestos is a fine-fiber mineral of the silicate class, often used in the construction industry, metal, glass, automotive and other industries. Asbestos dust is very dangerous; its inhalation can cause lung cancer , asbestosis , mesothelioma and other diseases. At the same time, decades can pass from the moment of contact with asbestos-containing materials to the onset of the disease. Among other factors, the influence of ionizing radiation, viral infection, contact with silicates, paraffins is not excluded.

Depending on the type of growth, peritoneal mesothelioma can be localized (nodular) or diffuse. In the first case, mesothelioma has the appearance of a limited node emanating from the parietal or visceral sheet of the peritoneum. With a diffuse form, mesothelioma has infiltrative growth without clear boundaries and spreads over the entire surface of the peritoneum. Diffuse peritoneal mesothelioma accounts for about 75% of all cases and is characterized by a more malignant course.

The progression of peritoneal mesothelioma is usually accompanied by the accumulation of serous or hemorrhagic exudate in the abdominal cavity and the development of ascites . With pleural mesothelioma , pleurisy is detected , pericardial mesothelioma – pericarditis .

According to the histological structure, epithelioid (50-70%), sarcomatoid (7-20%) and mixed (20-35%) forms of peritoneal mesothelioma are distinguished. A rare type of mesothelioma is the multicystic form, which occurs in women and affects the pelvic peritoneum, mainly in the pouch of Douglas. Given the localization of mesothelioma, its treatment can be carried out by oncologists in the field of pulmonology (thoracic surgery), cardiology , gastroenterology , gynecology .

Symptoms of peritoneal mesothelioma

In the initial stages, the manifestations of peritoneal mesothelioma are not very specific. There may be discomfort and pain in the abdominal cavity, which do not have a clear localization, weakness, weight loss. Dyspeptic disorders appear: nausea, loss of appetite, vomiting, intermittent diarrhea and constipation. In the future, as exudate accumulates in the abdominal cavity, there is an increase in the size of the abdomen , shortness of breath, and swelling. With nodular mesothelioma of the peritoneum during palpation, a mobile tumor formation can be determined. In some cases, there are signs of partial intestinal obstruction .

Peritoneal mesothelioma and other localizations are characterized by constant low-grade fever, arthralgia – pain in small joints of a volatile nature. Peritoneal mesothelioma rapidly disseminates by lymphogenous, contact, and implantation routes. Metastases of peritoneal mesothelioma can be found in regional lymph nodes, heart, lungs, liver, intestines, brain, bone marrow.

Diagnosis of peritoneal mesothelioma

Diagnosis requires a comprehensive instrumental examination and laboratory confirmation of peritoneal mesothelioma. A gastroenterologist or oncologist should always be alerted by the patient’s life history indicating previous contact with asbestos (work at a construction site, living in the area of ​​asbestos-cement plants, the presence of asbestos materials in the house, etc.).

If peritoneal mesothelioma is suspected, abdominal ultrasound , MSCT are performed to detect the presence of ascites and signs of a tumor process. To accurately confirm the diagnosis, it is necessary to perform laparocentesis in order to collect and study ascitic fluid. If malignant cells are not found in the exudate, they resort to diagnostic laparoscopy ( laparotomy ) and biopsy sampling with its subsequent morphological examination. Determination of the histological type of peritoneal mesothelioma is important for the prognosis and selection of antitumor treatment .

Treatment of peritoneal mesothelioma

The optimal treatment for nodular forms of peritoneal mesothelioma is radical surgical removal of the tumor. In order to evacuate ascitic fluid, therapeutic paracentesis procedures are performed.

Advertisements

With diffuse processes, radiation therapy , chemotherapy , or a combination of both is indicated. Chemotherapeutic drugs in various combinations (doxorubicin, methotrexate, cisplatin, vinorelbine, etc.) are administered both intravenously and directly into the abdominal cavity – intraperitoneally. Radiation therapy can be given as a stand-alone treatment, palliative care, or adjuvant treatment after surgery to suppress the growth of tumor cells.

Prevention and prognosis for peritoneal mesothelioma

To prevent the development of peritoneal mesothelioma, it is recommended to avoid contact with asbestos at work and at home.

The prognosis for the detection of peritoneal mesothelioma is unfavorable due to the rapid dissemination of the tumor. Usually, after diagnosis, patients live no more than 1-2 years. The best prognosis is observed with the epithelioid type of peritoneal mesothelioma; the worst – with sarcomatous and mixed.

Read more:

 

Advertisements

Leave a comment