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Peritoneal Mesothelioma: Specialized Care Approach

Rare aggressive peritoneal malignancy with multimodal treatment options

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Peritoneal Mesothelioma: Specialized Care Approach?

Peritoneal mesothelioma represents 10 to 20 percent of all mesothelioma cases.

Histologic subtypes include epithelioid (most common, better prognosis), sarcomatoid (worst prognosis) and biphasic.

Asbestos exposure is implicated in some cases though less consistently than in pleural disease; other risk factors include radiation, BAP1 germline mutations and erionite exposure.

Diagnosis requires tissue biopsy with characteristic histology, immunohistochemistry (calretinin, CK 5/6, WT-1) and exclusion of metastatic adenocarcinoma.

Imaging with CT, MRI and PET-CT defines extent and guides treatment planning.

Symptoms

Abdominal pain, distension and bloating progressing over months.
Ascites with weight gain, early satiety and reduced appetite.
Bowel obstruction symptoms including nausea, vomiting and altered bowel habits.
Constitutional symptoms with fatigue, weight loss and night sweats.
Palpable abdominal mass or umbilical nodule (Sister Mary Joseph) in advanced disease.

Risk Factors

Occupational or environmental asbestos exposure in some cases though less consistently than pleural disease.
BAP1 germline mutations as part of BAP1 cancer predisposition syndrome.
Erionite exposure in certain geographic regions.
Prior abdominal radiation therapy.
Family history of mesothelioma or BAP1-related cancers.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent unexplained abdominal pain, ascites or weight loss requires investigation.
  • Bowel obstruction symptoms or severe abdominal distention need urgent evaluation.
  • Recurrent ascites of unclear etiology warrants comprehensive workup including paracentesis, imaging and possible laparoscopy.
  • Family history of mesothelioma or BAP1-related malignancies should prompt genetic counseling consideration.
  • Long-term surveillance after treatment monitors for recurrence and second primary malignancies.

Treatment Methods

01
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the cornerstone for selected patients with limited disease.
02
Systemic chemotherapy with platinum and pemetrexed is standard for unresectable or advanced disease.
03
Immunotherapy with nivolumab plus ipilimumab is approved for unresectable malignant pleural mesothelioma and being studied in peritoneal disease.
04
BAP1 testing and emerging targeted therapies including PARP inhibitors in clinical trials for selected patients.
05
Multidisciplinary care at specialized centers, comprehensive supportive care, palliative interventions for ascites and bowel obstruction and clinical trial enrollment provide optimal management for this challenging disease.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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