Benign Multicystic Peritoneal Mesothelioma Mimicking Acute Appendicitis: A Case Report

Ethel Cassandra Ramírez Ortiz, Jorge Andrés Myers Esmenjaud, Salvador Medina González
In: International Journal of Medical Science and Clinical Research Studies · 2026 · vol. 06(03) · doi:10.47191/ijmscrs/v6-i3-22 · W7140199068
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A rare case of benign multicystic peritoneal mesothelioma mimicking acute appendicitis in a 34-year-old male was diagnosed and treated with laparoscopy and tumor resection.

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This case report describes a 34-year-old male presenting with acute right lower quadrant pain, initially suspected to be appendicitis but ultimately diagnosed with benign multicystic peritoneal mesothelioma via diagnostic laparoscopy. The patient underwent local tumor resection and appendectomy, with histopathology confirming the presence of multiple thin-walled cysts attached to the peritoneal surfaces. While the paper notes that this rare tumor is more frequent in women and associated with conditions like endometriosis or pelvic inflammatory disease, it does not study these conditions directly, focusing instead on an atypical presentation in a male patient. Relevance to endometriosis: listed as one of the potential associations for developing benign multicystic peritoneal mesothelioma, though the paper's main focus is a surgical case report in a male patient.

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Abstract

Background: Benign multicystic peritoneal mesothelioma is a rare tumor derived from mesothelial cells characterized by multiple thin-walled cysts attached to the peritoneal surfaces. It occurs more frequently in women and has been associated with previous abdominal surgery, endometriosis, or pelvic inflammatory disease. Despite its benign nature, it has a high recurrence rate after surgical treatment.Case presentation: We report the case of a 34-year-old male with a history of bilateral varicocelectomy and bilateral inguinal hernioplasty who presented to the emergency department with acute onset right lower quadrant abdominal pain suggestive of acute appendicitis. Laboratory tests showed elevated C-reactive protein levels. Abdominal computed tomography revealed multiple well-defined cystic lesions in the right lower abdomen and pelvis. Diagnostic laparoscopy was performed due to suspicion of a periappendiceal abscess, revealing a 6 × 4 × 2 cm multicystic tumor attached to the mesentery and right colon, along with multiple grape-like cystic lesions throughout the abdominal cavity. Local tumor resection, removal of most cystic lesions, and appendectomy were performed. Histopathological examination confirmed the diagnosis of benign multicystic peritoneal mesothelioma.Conclusion: This case highlights an uncommon presentation of benign multicystic peritoneal mesothelioma in a male patient mimicking acute appendicitis. Laparoscopy plays an important role in both diagnosis and treatment, allowing complete surgical resection. Long-term follow-up is recommended due to the risk of recurrence.
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Abstract

Background: Benign multicystic peritoneal mesothelioma is a rare tumor derived from mesothelial cells characterized by multiple thin-walled cysts attached to the peritoneal surfaces. It occurs more frequently in women and has been associated with previous abdominal surgery, endometriosis, or pelvic inflammatory disease. Despite its benign nature, it has a high recurrence rate after surgical treatment.Case presentation: We report the case of a 34-year-old male with a history of bilateral varicocelectomy and bilateral inguinal hernioplasty who presented to the emergency department with acute onset right lower quadrant abdominal pain suggestive of acute appendicitis. Laboratory tests showed elevated C-reactive protein levels. Abdominal computed tomography revealed multiple well-defined cystic lesions in the right lower abdomen and pelvis. Diagnostic laparoscopy was performed due to suspicion of a periappendiceal abscess, revealing a 6 × 4 × 2 cm multicystic tumor attached to the mesentery and right colon, along with multiple grape-like cystic lesions throughout the abdominal cavity. Local tumor resection, removal of most cystic lesions, and appendectomy were performed. Histopathological examination confirmed the diagnosis of benign multicystic peritoneal mesothelioma.Conclusion: This case highlights an uncommon presentation of benign multicystic peritoneal mesothelioma in a male patient mimicking acute appendicitis. Laparoscopy plays an important role in both diagnosis and treatment, allowing complete surgical resection. Long-term follow-up is recommended due to the risk of recurrence. Article Details This work is licensed under a Creative Commons Attribution 4.0 International License.

References

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