Benign Multicystic Omental Mesothelioma in Pregnancy: A Case Report and Review of the Literature

Abstract

Benign Multicystic Peritoneal Mesothelioma (BMPM) is a very rare condition of unknown pathogenesis, that occurs mainly in women in their reproductive age (5:1 female/male ratio). The pathogenesis of BMPM is unclear and doubts regarding its neoplastic and reactive nature exist. Furthermore, the differential diagnosis with other diseases remains uncertain. In most cases the diagnosis is accidental, during a laparotomy performed for other reasons, since the diagnostic imaging does not allow a definite diagnosis preoperatively. Radical surgical resection is the “gold standard” for treatment of BMPM, despite a high rate of recurrence (about 50%). We report on a case of a 30-year-old pregnant woman with multilocular omental cystic mass, 36 x 22 cm in size, underwent elective caesarean section at term of pregnancy. The definitive histologic diagnosis was benign multicystic mesothelioma of the omentum. BMPM detected in pregnancy or during cesarean delivery is very rare; in fact only three other cases have been reported. Particularly, we present the only case, described in the literature, of a young female with benign multicystic omental mesothelioma in pregnancy that was treated solely by surgery, without recurrence after three years follow-up. In this article we also describe diagnostic evaluation, treatment, prognosis of this rare disease as the possible positive effects of adjuvants medical treatments.