Cystic mesothelioma is a rare form of cancer affecting the abdomen’s lining. The cancer cells are typically found in the tissue surrounding the abdomen. The disease may be caused by exposure to asbestos, a mineral substance used in many building materials such as roofing, insulation, and floor tiles.
People with cystic mesothelioma are typically diagnosed when they have symptoms such as shortness of breath or coughing up blood. Treatment for this disease includes surgery as the primary treatment and supplemental therapies such as hormonal management or laser ablation.
Key Facts About Cystic Mesothelioma
- Cystic mesothelioma is also known as Benign Cystic Mesothelioma (BCM), as it usually does not spread throughout the body.
- Cystic mesothelioma usually develops in women but has been known to occur in men.
- It is exceptionally rare, with fewer than 150 cases reported since the first case described by Smith and Mennemeyer in 1979.
- The prognosis is usually good. The 5-year survival rate is 100% when a combination of treatments is given.
What Is Cystic Mesothelioma?
Benign cystic mesothelioma (BCM) is a very rare type of mesothelioma and may be caused by asbestos exposure. However, whereas all other types of mesothelioma are typically caused by exposure to asbestos, it is unclear if there is a link between asbestos and BCM.
Other names for the condition include:
- Benign multicystic peritoneal mesothelioma
- Benign papillary peritoneal cystosis
- Multilocular peritoneal inclusion cysts
- Postoperative peritoneal cysts
What Do Cystic Cells Look Like?
These tumors are multiple multilocular thin-walled cysts. These cystic tumors may be filled with mucinous or gelatinous fluid.
They may grow as large as 20 cm in diameter, meaning that they may impact nearby organs. These cysts may appear pale yellow in color when they have been removed from the body. When viewed on imaging scans, the cysts may also appear to have individual ‘chambers.’
In women, the tumors are usually found on the peritoneal surface of the uterus and rectum. In contrast, they typically occur on the peritoneal surface of the bladder and rectum when they develop in men.
What Causes Cystic Mesothelioma?
Whereas malignant mesothelioma is caused by asbestos exposure, it remains unclear how cystic mesothelioma develops.
The exact cause of cystic mesothelioma is unknown, but some studies suggest that it has a strong predilection for women, with around 90% of cases having been in people assigned female at birth. These patients often have a history of endometriosis, pelvic inflammatory disease, or prior surgeries. This suggests that there may be a connection between cystic mesothelioma and chronic irritation.
Symptoms of Cystic Mesothelioma
Cystic mesothelioma is a rare form of cancer with an unknown cause but may be linked to asbestos exposure. It starts in the lining of the abdomen, and it can be difficult to diagnose because it can take years for symptoms to appear.
Often, people will not experience symptoms until after the tumor or tumors become large enough to affect other organs in the body.
The most common symptoms of cystic mesothelioma are:
- chest pain
- coughing up blood or phlegm
- distended abdomen
- inflammation of the peritoneum
- intestinal obstruction
- loss of appetite
- menorrhagia, or prolonged or excessive menstrual periods
- menstrual spotting
- night sweats
- recurrent or persistent genital pain associated with sexual intercourse
- shortness of breath
If you have any of these symptoms and they persist for more than three weeks, it may be time to get a check-up. Although cystic mesothelioma is typically benign, it has been known to turn malignant, and regardless, people experiencing these symptoms should not have to experience them for longer than they have to.
Diagnosing Cystic Mesothelioma
Doctors will ask several questions to determine your medical history, including for how long you’ve been experiencing symptoms and what the symptoms are. They’ll also likely ask when the symptoms first occurred and if any activities worsen them.
One study suggests that for around 18% of people, the cystic mesothelioma tumor is an incidental finding, meaning that doctors may carry out tests for other diagnoses when they discover the tumor.
Doctors may carry out abdominal and pelvic ultrasounds, abdominal computerized tomography (CT) scans, or laparoscopic examinations, which will display abdominal multicystic separated grapelike structures.
A biopsy is a procedure in which tissue or cells are removed from the body for examination under a microscope. It can be used to diagnose and monitor diseases, injuries, and other conditions. A biopsy usually involves taking some cells from an area of concern, such as a tumor, and examining them under a microscope to determine their nature.
If imaging scans show suspicious structures, doctors may order a biopsy to be carried out. The tissue sample will be sent to a lab to check under a microscope, and if it is cystic mesothelioma, it will show vascularized, translucent fluid-filled, thin-walled cysts made up of loose connective tissue.
Immunohistochemistry is a technique that uses antibodies and antigens to identify cells or tissues in a tissue sample. This can be done by using different markers like an enzyme, radioisotope, or fluorescent marker. The main function of immunohistochemistry is to determine the type of cells present in the sample.
Expert pathologists can confirm that the tumors originated in the mesothelial cells when they review the sample. This can confirm the diagnosis of cystic mesothelioma.
What are the Treatment Options for Cystic Mesothelioma?
There is currently no standard treatment recommendation for cystic mesothelioma. However, most cases have been successfully treated using surgery. For other cases, a combination of treatment methods may be required.
This involves a surgeon making an incision in the patient’s body to remove the entirety of the cyst or multiple cysts. Cystic mesothelioma has a high recurrence rate in the same or nearby location, at around 50%, whereas it has never been reported to spread throughout the body.
People who have had surgery to remove cystic mesothelioma should have regular follow-up appointments to check for incidences of recurrences so that they can be once again removed if necessary.
Other treatment options that are often used in cases of cystic mesothelioma include:
- hormonal management
- laser ablation
- image-guided percutaneous drainage
These treatments are used to ensure the best possible chance of the full removal of the cysts and to aim for them not to recur.
What is the Prognosis for Cystic Mesothelioma?
With surgery to remove the tumors, the prognosis for cystic mesothelioma is excellent. As of November 2022, there have only been two reported cases of death connected to cystic mesothelioma.
The first case was a patient who had most of the tumor removed at age 14 but died 12 years later after it recurred, and they refused further treatment. This highlights the importance of removing the entire mesothelioma or having subsequent surgeries to remove any recurrences of it.
The second person to pass away in connection to benign cystic mesothelioma died as a result of sepsis following acute peritonitis due to the condition. The autopsy carried out showed that the cystic mass had trapped the bladder, rectum, and segments of the small intestine, which likely led to their death.
Read on to learn the answers to several frequently asked questions regarding cystic mesothelioma.
How common is benign mesothelioma?
There have been fewer than 150 reported cases of cystic mesothelioma. It occurs more frequently in women of childbearing age, though it has been known to develop in men and children.
What triggers mesothelioma?
Mesothelioma is a type of cancer that develops in the mesothelium, which is the tissue that covers the lungs, heart, and abdomen. Mesothelioma is caused by exposure to asbestos fibers. It can occur when asbestos fibers are inhaled or ingested. The most common way this occurs is through occupational exposure to asbestos.
However, the link between the disease and asbestos remains unclear for cystic mesothelioma.
What is multicystic mesothelioma?
Benign multicystic peritoneal mesothelioma (BMPM) is a very rare benign cystic tumor that develops in the lining of the abdominal wall, the peritoneal mesothelium. It is most common for women of childbearing age with a prior history of abdominal surgery, endometriosis, or pelvic inflammatory disease.
People may panic when they hear the term mesothelioma, especially as most of the information indicates that it is a terminal condition. However, people with cystic mesothelioma have an excellent prognosis compared to other types of mesothelioma.
Treatment should begin as soon as possible to ensure the best outcome. The next steps for people diagnosed with cystic mesothelioma are to speak to their healthcare providers to determine their treatment options and to attend any follow-up appointments required of them.