一例恶性腹膜间皮瘤误诊为结肠癌报道及文献复习

A case of malignant peritoneal mesothelioma was misdiagnosed as colon cancer and the literature review

恶性腹膜间皮瘤是一种起源于腹膜腔上皮或间皮组织的少见恶性肿瘤,起病隐匿,几乎无特异性临床表现、敏感性实验室指标及影像学明显特征,早期诊断困难,极易误诊,病理学及免疫组化诊断是其金标准。该病目前尚无标准治疗方案推荐,确诊时多为晚期,病死率高,预后极差。本文报道一例54岁男性,初始误诊为结肠癌合并腹腔积液,后在腹腔镜下探查及活检,方得以明确诊断,采用多种药物灌注而腹腔积液仍不能控制,胸腹腔积液引流总量达7万余毫升,如此大量腹腔积液在临床上较少见,其生存期15个月。本文加以报道与文献回顾,旨在提高对该病之认识。

Malignant peritoneal mesothelioma originates from the epithelial ormesenchymal tissue of the peritoneal cavity. It is a rare malignancy without speci?c clinical symptoms, sensitive laboratory examination and typical imaging features. The early diagnosis of malignant peritoneal mesothelioma is difficult and the mortality is high. The final diagnosis depends on pathology and immunohistological examination. For the time being there is not yet a de?nite treatment strategy. Most cases are diagnosed at late stage and its prognosis is poor. Here we reported one rare case to draw the attention of physicians through rough discussion and literature review: A 54-years old man, initially misdiagnosed as colon cancer combined ascites. The final diagnosis depended on laparotomy exploration and biopsy by laparoscope. Ascites was unable to control after local abdominal cavity chemotherapeutic instillation with many kinds of drugs and the total amount of ascites was more than 70 000 mL. The overall survival was 15 months.