Ultrasonographic misdiagnosis of multicystic mesothelioma of the omentum: A case report

Abstract

Rationale: Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.

Patient concerns: We report a case of a 34-year-old man with solid abdominal cystic echo mass. Physical examination showed that the patient had a flat and soft abdomen without tenderness or rebound pain, no fluid wave tremor, and no obvious abdominal mass was touched. The patient complained of repeated abdominal distention with nausea for 5 days. Sonographic examination suspected pseudomyxoma peritoneum.

Diagnosis: Conventional ultrasound examination showed a cystic solid echo mass in the right abdominal cavity of the patient, with uneven internal echo and honeycomb change, and clear boundary with surrounding organs. Color Doppler suggested that the blood flow in the mass was not obvious. Contrast-enhanced computed tomography of the abdomen revealed hypodensity foci in hepatic and renal crypts and right paracolic sulcus.

Interventions: Laparoscopic resection of the mass was performed, and the postoperative pathological findings were polycystic mesothelioma (greater omentum).

Outcomes: After mass resection, all laboratory tests and abdominal ultrasound were normal, and abdominal distension and nausea disappeared.

Lessons: Improved ultrasound diagnosis of MM is useful for clinical decision-making.