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Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management

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Abstract

Purpose

Peritoneal mesothelial cysts (PMC) are a clinical dilemma because of their true pathogenic nature. Many definitions have been associated with PMC, including “benign multicystic mesothelioma”, “cystic mesothelioma”, “multilocular peritoneal inclusion cysts”, ‘‘inflammatory cysts of the peritoneum” or “postoperative peritoneal cyst”.

Methods

We herein performed a systematic review of the literature focusing on clinical and histopathological aspects of PMC, diagnosis, and therapies. Moreover, we described our experience with a case of PMC in a young female.

Results

Since there is often a history of prior surgery or inflammatory disease, most authors consider PMC of reactive origin. However, in some cases they occur without any documentable signs of disease or injury. A variety of clinical findings can complicate the preoperative assessment and a multitude of histological pictures may potentially lead to a misdiagnosis. The absence of a uniform treatment strategy and lack of long-term follow-up often hinder the accurate definition leading to unnecessary or unnecessarily aggressive therapy.

Conclusions

PMC are more common than had previously been thought. Most authors consider them non-neoplastic; thus the designation of “peritoneal inclusion cyst” is preferable. The term “mesothelioma” should be used only in cases of histological evidences of atypia. The high rates of recurrence suggest that the goal of treatment should not be necessarily complete eradication, but symptomatic relief through individualized treatment. This is a topic of particular importance, especially in young female where recurrence rates could be lower than those reported in adults and where an improperly aggressive treatment could have repercussions on fertility.

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Acknowledgements

A thoughtful thanks to Mr. Antony Bridgewood for his support in the linguistic review process.

Funding

This study was not supported by any Grant/fund.

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Authors and Affiliations

  1. Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

    Agnese Maria Chiara Rapisarda, Antonio Cianci, Salvatore Caruso, Salvatore Giovanni Vitale & Gaetano Valenti

  2. Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria “Policlinico-Vittorio Emanuele”, Anatomic Pathology Section, School of Medicine, University of Catania, Catania, Italy

    Eliana Piombino

  3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy

    Stefano Cianci

Authors
  1. Agnese Maria Chiara Rapisarda
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  2. Antonio Cianci
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  3. Salvatore Caruso
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  4. Salvatore Giovanni Vitale
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  5. Gaetano Valenti
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  7. Stefano Cianci
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Contributions

AMCR: Project administration, Writing—original draft. AC: Writing—review and editing. SC: Writing—review and editing. SGV: Project administration, Writing—original draft. GV: Data curation. EP: Data curation. SC: Writing—original draft, Supervision.

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Correspondence to Salvatore Giovanni Vitale.

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The authors have no proprietary, financial, professional or other personal interest of any nature in any product, service or company mentioned in this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national 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 subject included in the study.

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Rapisarda, A.M.C., Cianci, A., Caruso, S. et al. Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management. Arch Gynecol Obstet 297, 1353–1375 (2018). https://doi.org/10.1007/s00404-018-4728-2

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  • DOI: https://doi.org/10.1007/s00404-018-4728-2

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