Peritoneal mesothelioma is a rare disease, especially when it arises in a c
ystic form with tardive and often nonspecific symptoms. While diffuse neopl
asms have an unfavorable prognosis, cystic forms are usually benign. An acc
urate diagnosis can only be made only with electron microscopy and immunohi
stochemical studies. A 92-year-old woman with an ultrastructurally ascertai
ned cystic peritoneal mesothelioma was admitted to the hospital's emergency
ward, and was considered to be unusual because of the size of the mass and
the patient's age. A review of the literature is made, and the clinical an
d diagnostic aspects of this disease are also discussed.