Diffuse malignant peritoneal mesothelioma - An uncommon differential diagnosis in adenocarcinomas of the ovary

Diffuse malignant mesotheliomas are uncommon aggressive tumors of serosal surfaces of body cavities. The incidence of these tumors is increasing worldwide, probably as a result of the widespread exposure to asbestos, a factor with which these tumors are associated. About 85% of mesotheliomas arise in the pleura, 9% in the peritoneum, a small percentage in the pericardium or tunica vaginalis testis. We report the case of a 51 year-old woman with ascites and abdominal pain who underwent laparotomy with the diagnosis of primary ovarian cancer with intraperitoneal spread. After surgery the diagnosis of a malignant peritoneal mesothelioma was considered. The patient is now undergoing treatment with systemic chemotherapy consiting of pemetrexed and cisplatin. intensive multimodal approaches that combine cytoreductive surgery with intraperitoneal hyperthermic perfusion have been evaluated in recent studies with encouraging results in small cohorts of patients. The prognosis of untreated patients is poor and the median survival is approximately one year.