Abstract:

Benign multicystic peritoneal mesothelioma (BMPM) is an exceedingly rare peritoneal neoplasm characterized by a high recurrence rate and potential for malignant transformation. Preoperative diagnosis remains challenging; lesions are usually encountered incidentally during surgery. Optimal management is controversial, and long-term postoperative surveillance is mandatory. We describe two patients with BMPM confirmed by postoperative histopathology. Case 1: a pelvic mass was incidentally detected on gynecologic ultrasound performed for abdominal distension. Laparoscopic evacuation of loculated pelvic fluid, resection of a right para-tubal cyst, and adhesiolysis were performed; ultrasound at 2 months showed no residual disease, but the patient was subsequently lost to follow-up. Case 2: the patient had undergone surgery for BMPM in 2021; four years later, recurrence was identified during evaluation for failed oocyte retrieval. Multifocal cystectomy and bilateral tubal ligation were completed, followed by assisted reproductive technology; no gynecologic follow-up has since been recorded. Preoperative diagnosis of BMPM is difficult, and clinicians need to strengthen differentation from disease with similar imaging findings. BMPM should be considered when multiple cystic peritoneal lesions are observed. A detailed occupational and prior surgical history is essential to improve pre-operative diagnostic accuracy.

Key words: Mesothelioma, cystic, Infertility, female, Diagnosis, Therapy, Prognosis