■恶性腹膜间皮瘤(MPM)是一种罕见的临床实体。很少报道MPM与其他恶性肿瘤如结肠腺癌的同步存在。鉴于其复杂性和稀有性,其诊断和管理具有挑战性。
■这里,我们报告了一例与乙状结肠腺癌同时发生的MPM上皮样亚型,以及文献综述。
■一名老年女性患者被称为直肠乙状结肠肿块。她报告有腹痛史,直肠出血,厌食症,和显著的体重减轻。她的腹部计算机断层扫描显示乙状结肠肿物和多个淋巴结肿大并伴有网膜结节。结肠镜检查显示有较大的基底肿块,内镜活检报告为结肠腺癌。患者被安排腹腔镜低位前切除术。然而,诊断性腹腔镜检查显示有几个结节散布在整个腹膜上,提示腹膜间皮瘤。因此,在从大网膜和腹膜结节进行多次活检后,将决定改为进行横向结肠造口术。组织病理学显示MPM,最终诊断为乙状结肠腺癌伴同步MPM。由于患者的一般状况,患者开始接受姑息性化疗(卡培他滨)而没有积极治疗MPM。她接受了良好的临床课程随访。
■MPM是一个被忽视的实体,临床表现模糊。与结直肠癌同步的MPM很少见,只有很少的已发表病例报告。它的诊断具有挑战性,它的管理应该根据病人而量身定做。该病例是沙特阿拉伯和中东报告的首例病例。
UNASSIGNED: Malignant peritoneal mesothelioma (MPM) represents a rare clinical entity. The synchronous existence of MPM with other malignancies as colonic adenocarcinoma have been rarely reported. Its diagnosis and management are challenging given its complexity and rarity.
UNASSIGNED: Herein, we report a case of epithelioid subtype of MPM occurring synchronously with sigmoid colonic adenocarcinoma, along with review of the literature.
UNASSIGNED: An elderly female patient was referred as case of rectosigmoid mass. She reported history of abdominal pain, per-rectal bleeding, anorexia, and significant weight loss. Her computed-tomography scan of the abdomen revealed a fistulizing sigmoid mass and multiple enlarged lymphnodes with omental nodulation. The colonoscopy revealed a large fungating mass and the endoscopic biopsies were reported as colonic adenocarcinoma. The patient was scheduled laparoscopic low anterior resection. However, the diagnostic laparoscopy revealed several nodules disseminated all over the peritoneum, suggestive of peritoneal mesothelioma. Therefore, the decision was changed to create transverse colostomy after examination obtaining multiple biopsies from the omental and peritoneal nodules. The histopathological revealed MPM and the final diagnosis was sigmoid adenocarcinoma with synchronous MPM. The patient was started on palliative chemotherapy (capecitabine) without active management of MPM because of her general condition. She was followed up with a good clinical course.
UNASSIGNED: MPM is an overlooked entity with vague clinical presentation. Synchronous MPM with colorectal cancer is rare with only few published case reports. Its diagnosis is challenging, and its management should be tailored according to the patient. This case is the first reported case in Saudi Arabia and the Middle East.