PERITONEAL MESOTHELIOMA IN RECURRENT FAMILIAL PERITONITIS

A 39-year-old man had a 2-year history of fatigue, weight loss, drug-r esistant ascites, and decreased intestinal motility. During adolescenc e he began to suffer frequent episodes of acute benign peritonitis tha t spontaneously subsided at age 35. The fact that his younger brother was taking colchicine for the same symptoms led us to diagnose familia l Mediterranean fever (FMF). The medical workup revealed uniform thick ening of the intestinal wall with no signs of amyloidosis. Exploratory laparotomy revealed diffuse peritoneal mesothelioma that proved to be unresponsive to chemotherapy. There was no history of asbestos exposu re. It is probable that the chronic peritoneal inflammation was respon sible for the development of this tumor, although in almost all cases of FMF this phenomenon causes only limited peritoneal fibrosis or, les s commonly, encapsulating peritonitis. A computerized search of the li terature indicates that this is the second report of peritoneal mesoth elioma associated with FMF.