Peritoneal Mesothelioma: A Review

Alessio Bridda, MD, Ilaria Padoan, MD, Roberto Mencarelli, MD, Mauro Frego, MD

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In This Article

Clinical Picture

Mesothelioma can arise both from visceral and parietal peritoneum. It is diagnosed in advanced stages in most cases, and it often takes considerable time to arrive at the correct diagnosis, as the mean symptoms-to-diagnosis time reported is 122 days.[3] The most frequently reported initial symptoms are abdominal pain (35%), abdominal swelling (31%), anorexia, marked weight loss, and ascites[3,15,16,17]; less frequently night sweats and hypercoagulability.[18] Clinical presentation with fever of unknown origin,[15] intestinal obstruction,[19] or surgical emergency (due to acute inflammatory lesions)[3,20] have been reported. In particular, compression of the gastrointestinal tract can complicate the disease, but it is rarely the presenting symptom. Occasionally the diagnosis has been made incidentally during laparoscopy.[21] Paraneoplastic syndromes associated with mesothelioma, and in particular with peritoneal mesothelioma, are thrombocytosis,[3] hypoglycemia,[9] venous thrombosis,[22] paraneoplastic hepatopathy, and a wasting syndrome.[23]

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