The case of a 67-year-old man complaining of abdominal pain is a sobering example of the challenges of diagnosing malignant peritoneal mesothelioma.
Malignant mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the body’s internal organs. When mesothelioma grows in the lining of the abdomen, it’s called malignant peritoneal mesothelioma.
Malignant mesothelioma is generally caused by exposure to asbestos. This exposure usually happens on the job, and it can take years for symptoms to appear.
In this case, the elderly man went to the emergency room for help with abdominal pain. This pain had been getting worse over the last month. He was also experiencing shortness of breath and fatigue.
After a physical examination, his doctor ordered a CT scan of his abdomen. A CT scan is a type of x-ray that creates a 3D image of the inside of the body. It can be helpful when doctors are trying to see if there are any tumors like mesothelioma.
However, the CT scan didn’t show any unusual growths.
Diagnosis and Testing Methods
Mesothelioma can be hard to diagnose. It can take decades for outward symptoms to appear after a person has been exposed to asbestos. It is also a rare disease, which means doctors don’t often think to look for mesothelioma in sick patients.
Because of these challenges, doctors must use more than one diagnostic method. One of these is imaging test like CT scans and x-rays.
Another method is testing fluid. When organ tissue is healthy, it produces a lubricating fluid. When this tissue becomes cancerous, it produces too much fluid. Doctors can test this fluid to look for cancer cells.
This is exactly what our patient’s doctor did next. They removed a sample of fluid from the patient’s abdomen and tested it for cancer cells. They found cells that looked like they could be cancerous mesothelioma cells.
Gold Standard Diagnosis for Mesothelioma
The gold standard of mesothelioma diagnosis is a tissue biopsy. This is when doctors take a sample of the suspected cancer tissue for closer examination.
This is what the patient’s doctor did to confirm the mesothelioma diagnosis. They took a sample of tissue from the patient’s abdomen and tested it for mesothelioma.
Sure enough, the tissue sample confirmed that the patient had malignant peritoneal mesothelioma.
This case study is all too typical of what mesothelioma patients go through to reach a diagnosis. Better diagnostic methods are needed to help these patients get the care they need.
Dusseault SK, Okobi OE, Thakral N, et al. Primary Peritoneal Mesothelioma: Diagnostic Challenges of This Lethal Imposter. Case Rep Gastroenterol. 2022;16(3):588-594. Published 2022 Nov 8. doi:10.1159/000523935. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830302/