Benign multicystic peritoneal mesothelioma (BMPM) is a very rare benign cystic tumor arising from the peritoneal mesothelium (lining of the abdominal wall).
There are (a) nine abdominal regions and (b) four abdominal quadrants in the peritoneal cavity.
Image by OpenStax College/Wikimedia
Summary
A cyst excised from a multicystic mesothelioma may look similar to this, and while multicystic mesothelioma may not be a true neoplasm, it has a stubborn tendency to recur locally.
Image by Ed Uthman, MD.
A cyst excised from a multicystic mesothelioma may look similar to this, and while multicystic mesothelioma may not be a true neoplasm, it has a stubborn tendency to recur locally.
This 8-centimeter cyst was incidentally found at hysterectomy floating free in the peritoneal cavity, a Zeppelin of the abdomen, if you will. Before making the diagnosis of this benign lesion, it is important for the pathologist to quiz the surgeon concerning the intra-abdominal findings. A cyst excised from a multicystic mesothelioma may look similar to this, and while multicystic mesothelioma may not be a true neoplasm, it has a stubborn tendency to recur locally.
Image by Ed Uthman, MD.
What Is Benign Multicystic Peritoneal Mesothelioma?
Benign multicystic peritoneal mesothelioma (BMPM) is a very rare benign cystic tumor arising from the peritoneal mesothelium (lining of the abdominal wall). It commonly occurs in young to middle-aged women who have a prior history of abdominal surgery, endometriosis, or pelvic inflammatory disease. The first symptoms usually include abdominal or pelvic pain, tenderness, and rarely, constipation and/or urinary hesitancy. Since it was first described in 1979, there have been approximately 130 cases described in the medical literature. BMPM is not related to prior asbestos exposure. The specific cause is unknown.
Source: Genetic and Rare Diseases (GARD) Information Center
The Peritoneum
What are the types of peritoneal dialysis?
Image by TheVisualMD
What are the types of peritoneal dialysis?
Peritoneal dialysis uses the lining of the abdomen (peritoneum), which is rich in arteries and veins, as a filter. Dialysis fluid is placed into the abdominal cavity through a permanent access port in the abdomen. The fluid remains there long enough for all the wastes in the blood to be transferred to the dialysis fluid, which is then drained out of the abdomen.
Image by TheVisualMD
The Peritoneum
The digestive organs within the abdominal cavity are held in place by the peritoneum, a broad serous membranous sac made up of squamous epithelial tissue surrounded by connective tissue. It is composed of two different regions: the parietal peritoneum, which lines the abdominal wall, and the visceral peritoneum, which envelopes the abdominal organs (image). The peritoneal cavity is the space bounded by the visceral and parietal peritoneal surfaces. A few milliliters of watery fluid act as a lubricant to minimize friction between the serosal surfaces of the peritoneum.
The Peritoneum
Figure 23.4 The Peritoneum A cross-section of the abdomen shows the relationship between abdominal organs and the peritoneum (darker lines).
A cross-section of the abdomen shows the relationship between abdominal organs and the peritoneum (darker lines).
The visceral peritoneum includes multiple large folds that envelope various abdominal organs, holding them to the dorsal surface of the body wall. Within these folds are blood vessels, lymphatic vessels, and nerves that innervate the organs with which they are in contact, supplying their adjacent organs. The five major peritoneal folds are described in the Table below. Note that during fetal development, certain digestive structures, including the first portion of the small intestine (called the duodenum), the pancreas, and portions of the large intestine (the ascending and descending colon, and the rectum) remain completely or partially posterior to the peritoneum. Thus, the location of these organs is described as retroperitoneal .
The Five Major Peritoneal Folds
Fold
Description
Greater omentum
Apron-like structure that lies superficial to the small intestine and transverse colon; a site of fat deposition in people who are overweight
Falciform ligament
Anchors the liver to the anterior abdominal wall and inferior border of the diaphragm
Lesser omentum
Suspends the stomach from the inferior border of the liver; provides a pathway for structures connecting to the liver
Mesentery
Vertical band of tissue anterior to the lumbar vertebrae and anchoring all of the small intestine except the initial portion (the duodenum)
Mesocolon
Attaches two portions of the large intestine (the transverse and sigmoid colon) to the posterior abdominal wall
DISORDERS OF THE...
Digestive System: Peritonitis
Inflammation of the peritoneum is called peritonitis. Chemical peritonitis can develop any time the wall of the alimentary canal is breached, allowing the contents of the lumen entry into the peritoneal cavity. For example, when an ulcer perforates the stomach wall, gastric juices spill into the peritoneal cavity. Hemorrhagic peritonitis occurs after a ruptured tubal pregnancy or traumatic injury to the liver or spleen fills the peritoneal cavity with blood. Even more severe peritonitis is associated with bacterial infections seen with appendicitis, colonic diverticulitis, and pelvic inflammatory disease (infection of uterine tubes, usually by sexually transmitted bacteria). Peritonitis is life threatening and often results in emergency surgery to correct the underlying problem and intensive antibiotic therapy. When your great grandparents and even your parents were young, the mortality from peritonitis was high. Aggressive surgery, improvements in anesthesia safety, the advance of critical care expertise, and antibiotics have greatly improved the mortality rate from this condition. Even so, the mortality rate still ranges from 30 to 40 percent.
Source: CNX OpenStax
Additional Materials (13)
Peritoneal Cavity - Part 1 - Anatomy Tutorial
Video by AnatomyZone/YouTube
The Peritoneum
A cross-section of the abdomen shows the relationship between abdominal organs and the peritoneum (darker lines).
Image by CNX Openstax
General Distribution of the Peritoneum
Cross section through the abdomen showing the continuity of the parietal and visceral peritoneum through the mesentery and the principal muscles that contribute to the abdominal wall.
Image by Dennis M DePace, PhD/Wikimedia
Mesentery
Mesentery
Image by Anatomist90
Mesentery
Horizontal disposition of the peritoneum in the lower part of the abdomen.
Image by Henry Vandyke Carter
Mesentery - structure of the gut wall
The general structure of the gut wall
Image by Auawise at English Wikipedia
Peritoneal Cavity
Cross section of the Peritoneal Cavity
Image by Dr. Johannes Sobotta
Peritoneum - 3D Schematic Anatomy & Relations
Video by About Medicine/YouTube
Peritoneum tutorial
Video by The Noted Anatomist/YouTube
Tracing the peritoneum in sections - simplified
Video by Human Anatomy Education/YouTube
4.3 what makes understanding the peritoneum so difficult?
Video by Centre for Innovation - Leiden University/YouTube
4.4 The relation of the peritoneum to the gut
Video by Centre for Innovation - Leiden University/YouTube
4.1 Introduction the peritoneum
Video by Centre for Innovation - Leiden University/YouTube
8:28
Peritoneal Cavity - Part 1 - Anatomy Tutorial
AnatomyZone/YouTube
The Peritoneum
CNX Openstax
General Distribution of the Peritoneum
Dennis M DePace, PhD/Wikimedia
Mesentery
Anatomist90
Mesentery
Henry Vandyke Carter
Mesentery - structure of the gut wall
Auawise at English Wikipedia
Peritoneal Cavity
Dr. Johannes Sobotta
5:10
Peritoneum - 3D Schematic Anatomy & Relations
About Medicine/YouTube
24:42
Peritoneum tutorial
The Noted Anatomist/YouTube
32:05
Tracing the peritoneum in sections - simplified
Human Anatomy Education/YouTube
4:46
4.3 what makes understanding the peritoneum so difficult?
Centre for Innovation - Leiden University/YouTube
6:20
4.4 The relation of the peritoneum to the gut
Centre for Innovation - Leiden University/YouTube
2:53
4.1 Introduction the peritoneum
Centre for Innovation - Leiden University/YouTube
Treatment
Surgery in operating room
Image by sasint/Pixabay
Surgery in operating room
Image by sasint/Pixabay
How Might Benign Multicystic Peritoneal Mesothelioma Be Treated?
Surgery to remove the cystic lesions is the only effective treatment for BMPM. Aggressive surgical approaches are often recommended. Hormonal therapy has also been attempted in individual cases with variable degrees of success. Most affected individuals do not undergo chemotherapy and/or radiotherapy because these tumors are usually benign.
Source: Genetic and Rare Diseases (GARD) Information Center
Prognosis
Prognosis Icon
Image by mcmurryjulie/Pixabay
Prognosis Icon
Image by mcmurryjulie/Pixabay
What Is the Long-Term Outlook for People with Benign Multicystic Peritoneal Mesothelioma?
Most people do well after surgery to remove the cysts. However, about 50 percent of patients experience a recurrence one to 27 years after their initial diagnosis. These cysts rarely become a malignant (cancerous). However, routine follow-up imaging is necessary after abdominal surgery in all patients because of the risk of recurrence.
Source: Genetic and Rare Diseases (GARD) Information Center
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Benign Multicystic Peritoneal Mesothelioma
Benign multicystic peritoneal mesothelioma (BMPM) is a very rare benign cystic tumor arising from the peritoneal mesothelium (lining of the abdominal wall).