Multicystic mesothelioma has malignant potential: its grounds and mechanisms of peritoneal metastasis

https://doi.org/10.4081/joper.2017.52

Authors

  • Yutaka Yonemura | y.yonemura@coda.ocn.ne.jp NPO Organization to Support Peritoneal Surface Malignancy Treatment, Oosaka, Japan; Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga, Japan.
  • Emel Canbay NPO Organization to Support Peritoneal Surface Malignancy Treatment, Oosaka, Japan.
  • Shouzou Sako NPO Organization to Support Peritoneal Surface Malignancy Treatment, Oosaka, Japan; Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
  • Satoshi Wakama Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
  • Haruaki Ishibashi Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
  • Masamitu Hirano Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga, Japan.
  • Akiyoshi Mizumoto Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga, Japan.
  • Kazuyoshi Takeshita NPO Organization to Support Peritoneal Surface Malignancy Treatment, Oosaka, Japan; Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
  • Nobuyuki Takao Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga, Japan.
  • Masumi Ichinose Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga, Japan.
  • Kousuke Noguchi Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kusatsu General Hospital, Shiga, Japan.
  • Yang Liu Department of Regional Cancer Therapy, Peritoneal Dissemination Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
  • Yan Li Department of Peritoneal Surface Oncology, Beijin Shijitan Hospital of Capital Medical University, Beijin, China.
  • Keizou Taniguchi Department of Surgery, Mizoguichi Hospital, Teikyou University, Tokyo, Japan.

Abstract

From 2009 to 2016, 9 female patients with multicystic peritoneal mesothelioma (MCPM) underwent 11 cytoreductive surgeries (CRS). Mean age at diagnosis was 50.6 (range, 43-71). Mean peritoneal cancer index was 8.9 (range, 2~33). Most frequent peritoneal sector involved was pelvic peritoneum in 7 patients, and greater omentum was involved in 6 patients. Eight and 1 patients had complete CRS and incomplete CRS, respectively. Except 1 patient, 8 patients had multiple cysts on different peritoneal sectors, and diffuse involvement on peritoneal surface was found in 2 patients No patients had lymph node metastasis or extraperitoneal spread. However, 3 patients showed pushing invasion to small bowel mesentery, colon, umbilicus and stomach. Median- follow-up was 46 months (range 4-120). At the time of the present analysis, all patients were alive. One patient recurred in peritoneal cavity 47 month after complete cytoreduction. Peritoneal free-floating cysts (PFFC) were found in 8 of 9 (88.9%) patients. Sizes of PFFC ranged from 1 mm to 2 cm in diameter and the inner surfaces were covered with mesotheliallike cells. MIB-1 labeling rates of PFFC ranged from 0.1% to 2.0%. These results indicate that PFCC may attach on the orifice of subperitoneal lymphatic vessels, and may become metastatic. The present study strongly suggests that MCPM has a potentially malignant behavior. This category of disease is composed of 2 types: diffuse type and localized type with borderline malignant potential. PFFC have an important role in the formation of peritoneal metastasis.

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Published
2017-06-06
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Original Articles
Keywords:
Multicystic mesothelioma, peritonectomy., peritonectomy
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How to Cite
1.
Yonemura Y, Canbay E, Sako S, Wakama S, Ishibashi H, Hirano M, Mizumoto A, Takeshita K, Takao N, Ichinose M, Noguchi K, Liu Y, Li Y, Taniguchi K. Multicystic mesothelioma has malignant potential: its grounds and mechanisms of peritoneal metastasis. J Peritoneum [Internet]. 2017Jun.6 [cited 2020Sep.26];2(1). Available from: http://www.jperitoneum.org/index.php/joper/article/view/52

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