Page 63 - Read Online

Farkas et al. J Cancer Metastasis Treat 2022;8:37 https://dx.doi.org/10.20517/2394-4722.2022.89 Page 9 of 13

Figure 9. Decisional algorithm for the work-up of serosal lesions.

PERITONEAL MESOTHELIOMA
Peritoneal mesothelioma is the second most common type of mesothelioma, accounting for 10%-15% of all
[52]
mesotheliomas . Interestingly, it has been noted that today, peritoneal mesotheliomas appear more
frequently in women and younger people than their pleural mesothelioma counterparts [53-56] . Peritoneal
mesothelioma is classified into the same histologic subtypes as pleural mesothelioma (epithelioid, biphasic,
and sarcomatoid). Recent data show that peritoneal mesotheliomas appear to have a better prognosis than
[57]
pleural mesotheliomas . In some cases, this may be due to different treatment options available based on
native anatomical location (hyperthermic intraperitoneal chemotherapy) . Biphasic and sarcomatoid
[58]
mesotheliomas are relatively rare compared to their thoracic counterpart but, when identified, show a
[59]
similar poor prognosis .
As mentioned above, there can be challenges differentiating mesothelioma from carcinoma. This problem is
just as evident in the peritoneal cavity as in the thoracic cavity. Therefore, most ancillary studies performed
to determine diagnosis concentrate on separating peritoneal mesothelioma from other diffuse peritoneal
malignancies, mainly papillary serous carcinoma, using immunohistochemical stains adapted from those