Diffuse Peritoneal Malignant Mesothelioma Presenting with Abnormal Uterine Bleeding: Case Report

Ivana Rizzuto; Theresa Power; Martin Klaus Oehler

doi:10.1159/000522608

Diffuse Peritoneal Malignant Mesothelioma Presenting with Abnormal Uterine Bleeding: Case Report

Case Rep Oncol. 2022 Mar 14;15(1):251-256. doi: 10.1159/000522608. eCollection 2022 Jan-Apr.

Authors

Ivana Rizzuto¹, Theresa Power², Martin Klaus Oehler^{1

3}

Affiliations

¹ Department of Gynaecological Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
² Department of Anatomical Pathology, SA Pathology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
³ Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.

Abstract

This report describes a highly unusual case of malignant peritoneal mesothelioma (MPM), who presented with abnormal menstrual bleeding due to diffuse infiltration of the uterus. MPM is a rare entity, which on initial clinical presentation can be indistinguishable from a primary gynecological malignancy such as ovarian cancer. As differential diagnosis is challenging among primary care physicians, gynecologists, gynecological oncologists, and pathologists, misdiagnosis and subsequent mismanagement are not uncommon. Immunohistochemical stains were required in our case to help to make the final diagnosis. We included multiple mesothelial markers such as calretinin, CK5/6, WT-1, and D240 in our analysis, in addition to epithelial markers such as Claudin-4, BerEP4, B72.3, and PAX-8, to exclude metastatic adenocarcinoma.

Keywords: Malignant peritoneal mesothelioma; Mesothelioma; Pleural mesothelioma.

Publication types

Case Reports