Well-differentiated papillary mesothelioma of the uterine serosa identified at cesarean section: a case report.

BACKGROUND

Peritoneal mesotheliomas encompass a variety of benign and malignant neoplasms. Well-differentiated papillary mesothelioma (WDPM) is uncommon, is thought to be of low malignant potential and is often discovered incidentally during abdominal or pelvic surgery. We describe a highly unusual case in which WDPM arising from the uterine serosa was identified at the time of cesarean delivery.

CASE: A 21-year-old primigravida underwent cesarean delivery at term for arrest of the active phase of labor. A 2-cm, polypoid lesion was excised from the posterior uterine fundus; final pathology showed well-differentiated papillary mesothelioma. Subsequent examination and computed tomography were negative. A follow-up laparoscopic examination with abdominal washing for cytology and peritoneal biopsies revealed no residual disease.

CONCLUSION

Survey of the pelvic cavity during cesarean section is important. Knowledge of the variable disease spectrum of mesothelioma is important in patient counseling and management. Differentiating between WDPM and malignant mesothelioma, other peritoneal tumors and implants from primary sites is necessary to avoid overtreatment.