Rare localization of malignant peritoneal mesothelioma

Peritoneal mesothelioma represents a rare disease, among its manifestations it can be encountered ascites and tumoral abdominal masses and this condition, untreated can lead to death by bowel obstruction, perforation and cachexia. Due to the rarity of the disease, some patients are misdiagnosed and thus they cannot benefit from a radical form of treatment which leads to an increased survival. We hereby present the case of a 62 year-old male with previous surgery for a retroperitoneal tumor with relapse of the disease. The pathological examination and immunochemistry showed a diffuse peritoneal mesothelioma with poor differentiation. The patient was submitted to chemotherapy and 16 months after surgery on regular control imaging he presented a retroperitoneal recurrence. Unfortunately the patient refused the treatment; we believe that he could benefit from radical surgery associated with hyperthermic intraperitoneal chemotherapy. Preoperative diagnosis of diffuse peritoneal mesothelioma can be difficult due to the lowest predictability of the clinical and imaging studies.