peritoneal mesothelioma

Peritoneal mesothelioma (peritoneal mesothelioma) in the primary peritoneal mesothelial epithelium and the tumor, clinical rarely see. Pathology can be categorized as adenomatous mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma), and malignant mesothelioma (peritone al malignant mesothelioma, PMM). The first two are benign. Cystic Mesothelioma more common in women, cause unknown, occurs in the pelvic or around the annex, was single or multiple cystic masses; Patients often palpable abdominal mass and treatment. SILVER malignant mesothelioma about 30%; Its incidence is also closely linked with exposure to asbestos. About 5% of patients with history of exposure [1]; Asbestos fibers oral intake, translocation through the intestinal wall into the peritoneal and pathogenicity. From exposure to asbestos that were diagnosed, the disease incubation period could be as long as 25 ~ 40 years. But domestic 1951 ~ 1993 20 literature analyzing 161 cases only one cases with asbestos exposure history. In the absence of a history of exposure to asbestos population, the incidence rate of about 1 / 1 million a year, may be some infection and genetic factors [2,3,4]. Abroad have reported a case of analyzing patients 40 years ago, I contacted glial thorium dioxide (Thorotrast) [ 5]. SILVER often occurred in men over the age of 40. Visceral or parietal peritoneum and may happen; Tumors can be a direct violation of abdominal, pelvic organ; 50% ~ 70% of patients with lymphatic and (or) hematogenous metastasis distant as liver, kidney, adrenal gland, lung, bone and lymph node, and so on. Clinical manifestations of this lack of specificity, and may have abdominal pain, constipation, swelling, weight loss and other obstruction performance [6]. Physical examination can be found ascites or abdominal mass. Ascites exudate part of gutsy. The disease often misdiagnosed as tuberculosis peritonitis and recurrent spontaneous bacterial peritonitis, mesenteric inflammation or peritoneal metastasis of cancer, and so on. Ascites hyaluronic acid increased significantly, "0.8 g / L were only found in analyzing. Ascites cytology has a certain value, but often difficult to judge. Serum carbohydrate antigen 125 (CA125) increased help diagnosis of the disease [6,7]. Ultrasound and CT performance varied, the typical person irregularly thickened peritoneum, omentum was Caky adhesions, tissue samples were mesenteric; CT may also show increased Peripancreatic large mass, or intraperitoneal substantive diffuse large mass, and bowel and mesenteric violations; or peritoneal nodules or showed a cystic mass; more with different degree of ascites [8]. Ultrasound or CT-guided biopsy is a definite value. Laparoscopy is analyzing the diagnosis of simple and effective method of endoscopic see peritoneum, omentum and diffuse nodular plaque, may look biopsy pathology examination. We had given one 83-year-old male patient laparoscopy, peritoneal biopsy report mesothelial cell hyperplasia, After immunohistochemical tests confirmed analyzing side. Butchart and others will be divided into four SILVER : I, confined to the peritoneal tumor; Phase II, intraperitoneal tumor invasion lymph nodes; Phase III, to the peritoneal tumor metastasis outside; Ⅳ, distant metastasis. These classifications will help choose the method of treatment. SILVER so far no effective standard treatment programs. The prognosis is poor, survival after diagnosis for a period, the median survival of more than two years of less than 20%. Mainly died for cachexia, or obstruction, and the cause of death rarely distant metastasis of the tumor.