Cystic mesothelioma is a benign form of mesothelioma that occurs in the peritoneum; a small layer of cells lining the abdominal walls and organs within the abdomen. This type of mesothelioma is non-cancerous and is usually not life threatening. If it is medically necessary to remove cyst from the peritoneum, surgery may be required. However, cystic mesothelioma often returns after initially removing the cysts.
Cystic mesothelioma is very rare, but most often occurs in women with a fully developed reproductive system, though a few cases have developed in the abdomen of men. Very little is known in the medical community about the reason that cystic mesothelioma may develop because there are few documented cases. The most common connection among cases of cystic mesothelioma includes previous pelvic trauma such as surgery or a medical condition such as endometriosis or inflammatory disease.
Cystic mesothelioma is not definitively linked to asbestos exposure and is not considered as severe as malignant mesothelioma because it is non-cancerous and cannot metastasize. It is not life threatening. It is classified as mesothelioma because the cysts develop within the mesothelium in the abdomen (or directly on the mesothelium) and have mesothelium lining. Cystic mesothelioma is typically removed by medical necessity and typically requires no cancer drug treatments, except in very specific circumstances.
Though cystic mesothelioma is no life-threatening, it is a serious condition which must be addressed and monitored over the lifetime of the individual. It can cause other complications and discomfort as cysts grow larger, especially in cases where they are in close proximity to an organ. The presence of cysts can also complicate the treatment of other conditions in the abdomen. While this disease is not nearly as worrisome as malignant mesothelioma, it can become a significant problem if left unchecked.
Cystic Mesothelioma Symptoms
Cystic mesothelioma is often asymptomatic (no symptoms are presented in the patient). However, symptoms may begin to be exhibited by the individual as tumors begin to grow larger. The severities of symptoms typically grow proportionately with the size of the tumor. As the tumor becomes larger, it causes more pain or tenderness. The most common symptoms of cystic mesothelioma are general to a variety of other conditions and include:
- Abdominal Swelling
- Abdominal Pain
- Abdominal Tenderness
- Palpable Mass in the Abdomen
Because these symptoms are common to many other conditions, diagnosis required specific testing and image scans to discover the cause symptoms.
Cystic Mesothelioma Diagnosis
Because cystic mesothelioma is often asymptomatic, discovery and diagnosis is commonly incidental and occurs during routine examinations or during diagnostic tests for other conditions. Otherwise, diagnosis is made based on the exclusion of more common conditions that cause identical symptoms, such as:
- Lymphangioma
- Ovarian Crystadenoma
- Crystadenomacarcinoma
- Endometriosis
- Teratoma
- Psuedomyxoma Peritonei
- Leiomyosarcoma
- Epithelial Inclusion Cysts
- Necrotic Leiomyoma
Since so many other conditions cause the symptoms of cystic mesothelioma, image scans of the region are required to diagnose the condition. As with all tumors, masses, or cysts in the body cavity, a biopsy test is the only conclusive method through which cystic mesothelioma can be diagnosed. However, much information is gleaned from images taken of the abdominal cavity that point to a mesothelial cyst. A sonogram, computerized tomography (CT) scan, and magnetic resonance imaging (MRI) scan may be recommended by doctors to first screen for visible signs of a problem.
Biopsy is typically completed following the discovery of a cyst in the abdomen. Malignant mesothelioma is most often tested using a needle biopsy method. However, cystic mesothelioma diagnosis calls for a laparoscopic biopsy to be performed.
During laparoscopic biopsy, a surgeon will make a small incision in the abdomen through which a small camera is inserted. The camera is outfitted with a cutting tool that allows the surgeon to both see the mass within the abdomen and take a sample for further examination.
A sample of the tissue is then taken to a pathology lab where it is examined under a microscope for signs of cancer. Here, pathologists are able to conclude with certainty that the cysts are composed of non-cancerous (benign) cells and are not life-threatening.
Cystic Mesothelioma Treatments
There is no specific protocol that is a universally accepted method of treating cystic mesothelioma. Surgery is the most common and effective form of removing cystic mesothelioma, though it is between 50% and 60% likely to redevelop at a later time.
It is preferable to remove all of the tumor mass from the abdomen in order to prolong the amount of time it will take for the cyst to redevelop. When cystic mesothelioma is limited to a region of the abdomen which proves little risk to other structures within the body cavity, a total resection (removal) of the mass is performed.
In some cases, cystic mesothelioma may grow to become very large before being diagnosed and treated. Large tumors tend to extend into sensitive areas of the abdomen where surgical removal poses a significant risk to health y structures. Because it is not always possible to remove the entire tumor mass. In these cases, surgeons may choose to “debulk” the mass by removing a large portion of it from the body cavity. A common debulking procedure for this purpose is termed “cytoreduction”.
Treatment of cystic mesothelioma carries the potential for side effects and complications. Any time surgery is performed to remove a tumor form the body cavity, common risks are posed and the patient must be monitored so that the effects may be treated. Surgery, regardless of the reason, can cause infection, sore throat, and allergic reactions to anesthesia. Possible complications due to tumor resection may also include:
- Bleeding
- Difficulty in urination or constipation
- Hypertension
- Abdominal pain
- Abdominal discomfort
Cystic Mesothelioma Treatment Follow Up
As stated previously, cystic mesothelioma has a fairly high recurrence rate. This is especially true following cytoreduction since some portions of the tumor remain in the body. In order to mitigate the growth rate of the tumor and to destroy as much of the mass as possible, further treatments may be necessary following surgical resection. A hopeful method of follow up surgery includes “washing” the abdominal cavity with medication. Doctors introduce drugs directly into the abdominal cavity where they come into contact with cysts directly. The drugs are not left in the cavity and since the drugs were not introduced intravenously, they have less of an impact on healthy cells in the body.
