Anzeige
Erschienen in:
06.03.2018 | Review
Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management
Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 6/2018
Einloggen, um Zugang zu erhaltenAbstract
Purpose
Peritoneal mesothelial cysts (PMC) are a clinical dilemma because of their true pathogenic nature. Many definitions have been associated with PMC, including “benign multicystic mesothelioma”, “cystic mesothelioma”, “multilocular peritoneal inclusion cysts”, ‘‘inflammatory cysts of the peritoneum” or “postoperative peritoneal cyst”.
Methods
We herein performed a systematic review of the literature focusing on clinical and histopathological aspects of PMC, diagnosis, and therapies. Moreover, we described our experience with a case of PMC in a young female.
Results
Since there is often a history of prior surgery or inflammatory disease, most authors consider PMC of reactive origin. However, in some cases they occur without any documentable signs of disease or injury. A variety of clinical findings can complicate the preoperative assessment and a multitude of histological pictures may potentially lead to a misdiagnosis. The absence of a uniform treatment strategy and lack of long-term follow-up often hinder the accurate definition leading to unnecessary or unnecessarily aggressive therapy.
Conclusions
PMC are more common than had previously been thought. Most authors consider them non-neoplastic; thus the designation of “peritoneal inclusion cyst” is preferable. The term “mesothelioma” should be used only in cases of histological evidences of atypia. The high rates of recurrence suggest that the goal of treatment should not be necessarily complete eradication, but symptomatic relief through individualized treatment. This is a topic of particular importance, especially in young female where recurrence rates could be lower than those reported in adults and where an improperly aggressive treatment could have repercussions on fertility.