Diagnosis Approach of Non-Hepatic Ascites: Peritoneal Mesothelioma

Abstract

Malignant mesothelioma is a heterogeneous disease and peritoneal mesothelioma (PM) is an uncommon aetiology of nonhepatic ascites. Asbestos exposure is not directly associated with the disease progression and symptoms are non specific, which delays the diagnosis. Radiology assessment and exploratory laparoscopy (with biopsy) are the main strategies to achieve and confirm PM diagnosis. Laparoscopy also plays an important role in staging. Due to its prevalence, few prospective trials or evidenced-based recommendations exist. Treatment options are often extrapolated from pleural mesothelioma. In this paper, the authors present an ascites diagnosis workup that leads to a PM. This case reflects the difficulty of the diagnosis.