Recurrent peritoneal mesothelioma with long-delayed recurrence

Peritoneal mesothelioma is a rare malignancy with a poor prognosis. Etiolog y is unclear and presentation of this disease is often atypical. There are very few cases of long-term survival in patients with peritoneal mesothelio ma. We report the case of a patient with peritoneal mesothelioma of 19 year s' duration. To the best of our knowledge, there have been no reports of re current peritoneal mesothelioma with such long-delayed recurrence and survi val. Recurrent peritoneal mesothelioma in the current patient was confirmed by comparing the biopsies of omentum taken in 1979 with that taken in 1997 . An extensive literature search was undertaken to look for previous report s of recurrent peritoneal mesothelioma. Aggressive and intensive chemothera py appeared to provide a longer survival time. Our patient had paraneoplast ic manifestations that included paraneoplastic hepatopathy and a wasting sy ndrome. Peritoneal mesothelioma is a rare malignancy with one to two cases per million in the United States. It is known to exhibit unusual paraneopla stic manifestations, including paraneoplastic hepatopathy, Treatment is oft en unsuccessful, with a median survival time of approximately 18 months fro m diagnosis. A better understanding and aggressive management of this disea se appear to help prolong survival.