Giant primary malignant mesothelioma of the liver: A case report

Ruba Haji Ali; Mohamad Khalife; Ghina El Nounou; Ruba Zuhri Yafi; Hussein Nassar; Zeinab Aidibe; Randa Raad; Rania Abou Eid; Walid Faraj

doi:10.1016/j.ijscr.2016.11.001

Giant primary malignant mesothelioma of the liver: A case report

Int J Surg Case Rep. 2017:30:58-61. doi: 10.1016/j.ijscr.2016.11.001. Epub 2016 Nov 11.

Authors

Ruba Haji Ali¹, Mohamad Khalife², Ghina El Nounou², Ruba Zuhri Yafi¹, Hussein Nassar², Zeinab Aidibe³, Randa Raad², Rania Abou Eid², Walid Faraj⁴

Affiliations

¹ Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
² Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon.
³ American University of Beirut, Faculty of Arts and Sciences, Department of Biology, P.O. Box 11-0236, Beirut, Lebanon.
⁴ Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon. Electronic address: wf07@aub.edu.lb.

Abstract

Introduction: Malignant mesothelioma is a rare neoplasm of mesothelial cells arising most frequently in the pleura or peritoneum and less frequently in the liver.

Case presentation: We present a case of primary hepatic mesothelioma of 41year old woman. She had no history of asbestos exposure or cancer. Abdominal computed tomography (CT) showed 21cm intrahepatic mass in the right lobe with many cystic lesions and few small calcifications. Pathology showed a biphasic cellular pattern. In addition, the tumor cells were positive for Calretinin, Creatine Kinase (CK)5/6, CK7, CKAEI 1/3, Wilms Tumor protein (WT-1), and Vimentin, but were negative for Alpha Feto protein (AFP), Thrombotic Thrombocytopenic Purpura (TTP-1), Anti-Hepatocyte Specific Antigen (HSA), Synaptophysin, CK20, and Homeobox protein (CDx-2).

Discussion: Primary intrahepatic mesothelioma (PIHMM) is not included in the classification of the World Health Organization classification of hepatic tumors. Mesothelial cells are not normally found in the liver, but some reported cases suggest it may grow from the mesothelial cells of the Glisson's capsule.

Conclusion: The probability of hepatic mesothelioma should not be ruled out, even in a young woman without a clear history of asbestos exposure.

Keywords: Case report; Liver; Malignant mesothelioma.