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Open Access Case report

Long-term survival of a woman with well differentiated papillary mesothelioma of the peritoneum: a case report and review of the literature

Jeffrey M Clarke1* and Paul Helft2

Author Affiliations

1 Department of Medicine, Duke University Medical Center, Durham, NC, USA

2 Department of Medicine, Section of Hematology/Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA

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Journal of Medical Case Reports 2010, 4:346  doi:10.1186/1752-1947-4-346

Published: 29 October 2010

Abstract

Introduction

Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare subtype of epitheloid mesothelioma, which is usually seen in young women. WDPMP is generally considered of low malignant potential, however the long-term nature of the tumor remains poorly defined.

Case presentation

We describe the long-term follow-up of a 60-year-old woman of West African descent who has survived 24 years with WDPMP after receiving extensive local and systemic adjuvant chemotherapy. Her clinical course has included three exploratory laparotomies with intraperitoneal and intravenous chemotherapy over two decades. Her course was complicated by anthracycline-induced cardiomyopathy, for which she underwent an orthotopic heart transplant. Our patient is alive with stable radiological evidence of peritoneal disease, and continues to suffer from chronic abdominal pain.

Conclusion

No consensus exists regarding optimal treatment strategies for WDPMP. However, given the low malignant potential of the tumor, careful consideration should be made before proceeding with aggressive interventions. Further, long-term follow-up reports are required to fully characterize this tumor.