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Localized biphasic malignant peritoneal mesothelioma presenting as a rectal tumor

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Abstract

An 84-year-old male presented with bloody stool. On digital rectal examination, a large and firm tumor was palpated in the anterior wall of the rectum at 2 cm from the anal verge. The colonoscopy revealed an ulcerated mass with smooth margins in the anterior wall of the rectum. Enhanced computed tomography showed a huge tumor in the pelvis, invading rectum, urinary bladder and the prostate, with signs of splenic and peritoneal metastases. Findings from an endoscopic biopsy and endoscopic ultrasound-guided fine needle aspiration suggested spindle cell carcinoma. We tentatively diagnosed as spindle cell carcinoma of the rectum and administered panitumumab as palliative chemotherapy. He eventually died at 4 months after the first visit to our institution. The autopsy findings resulted in the confirmed diagnosis as biphasic malignant peritoneal mesothelioma. There are only four previous reports on malignant peritoneal mesothelioma presenting as a colorectal tumor. Although rare, malignant peritoneal mesothelioma should be considered in differential diagnosis of colorectal tumors.

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Acknowledgments

The authors thank Dr. Paul Kawachi at Open Education Network kawachi@open-ed.net, for English proofreading.

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Authors and Affiliations

  1. Department of Surgery, Oita Sanai Medical Center, 1213, Oaza-ichi, Oita city, Oita, 870-1151, Japan

    Kohei Saisho, Shozo Fujiwara, Katsuhiro Anami & Ryoichi Matsumoto

  2. Department of Diagnostic Pathology, Faculty of Medicine, Oita University, 1-1, Idaigaoka, Hasama-machi, Yufu, 879-5593, Japan

    Takahiro Kusaba & Tsutomu Daa

  3. Department of Pathology, Fukuoka University School of Medicine and Hospital, 7-45-1, Nanakuma, Jonan-ku, Fukuoka City, Fukuoka, 814-0180, Japan

    Kazuki Nabeshima

  4. Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume City, Fukuoka, 830-0011, Japan

    Yoshito Akagi

Authors
  1. Kohei Saisho
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  2. Shozo Fujiwara
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  3. Katsuhiro Anami
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  4. Ryoichi Matsumoto
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  5. Takahiro Kusaba
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  6. Tsutomu Daa
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  7. Kazuki Nabeshima
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  8. Yoshito Akagi
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Correspondence to Kohei Saisho.

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All authors declare that have no conflicts of interest.

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All procedure performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from the patient’s family in this case report because the patient was dead.

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Saisho, K., Fujiwara, S., Anami, K. et al. Localized biphasic malignant peritoneal mesothelioma presenting as a rectal tumor. Clin J Gastroenterol 13, 308–315 (2020). https://doi.org/10.1007/s12328-019-01051-0

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  • DOI: https://doi.org/10.1007/s12328-019-01051-0

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