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Aggressive multimodality treatment for primary malignant peritoneal mesothelioma

There is a well-recognized link between asbestos and mesothelioma. 3 The peritoneal variant appears to be related more to heavy asbestos exposure, whereas the pleural tumour predominates in the much larger number of transiently exposed patients. It must be noted that only half the patients with pleural and peritoneal mesothelioma have documented asbestos exposure. Primary malignant peritoneal mesothelioma is a rare disease of the abdominal cavity that was first described in 1908 and accounts for approximately 15% of all mesotheliomas. 4 It can be classified into diffuse, well-differentiated papillary, and multicystic mesothelioma. 5 The diffuse malignant form occurs between the ages of 45 and 65 years, predominantly in men and tends to be aggressive and rapidly fatal. 6 Local invasion and metastases are common. 7 Most patients with diffuse peritoneal mesothelioma die within 1 year of diagnosis of the disease and approximately 14 months after the onset of symptoms. The disease follows a more lethal course compared to the pleural variant. 4,6–9