A Case of Early Rectal Cancer with Malignant Peritoneal Mesothelioma

Toshiki Yamakawa, Ichio Suzuka, Masaki Tokumo, Tomo Oka, Ryuichirou Ohashi and Kunihiko Shiota

Department of Surgery, Kagawa Prefectural Central Hospital

We report a case of early rectal cancer with malignant peritoneal mesothelioma. A 87-year-old man admitted for severe constipation and abdominal fullness was found in colonoscopy to have a hemicircumferential type II tumor in the lower rectum, diagnosed as well differentiated adenocarcinoma. Barium enema showed rectal stenosis for about 10 cm induced by wall thickening. Based on a diagnosis of diffuse infiltrative rectal cancer, we conducted abdominoperineal resection of the rectum. Intraoperative findings showed slight yellow ascites and severe thickening of the mesorectum. Histopathologically, the rectal lesion was early rectal cancer, but the mesorectal lesion suspected of invasion of rectal cancer was malignant mesothelioma with metastatic lymph nodes. Differential diagnosis between peritoneal invasion of diffuse infiltrative rectal cancer is very difficult. We must keep malignant peritoneal mesothelioma in mind when finding peritoneal thickening.

Key words
malignant peritoneal mesothelioma, diffuse infiltrative rectal cancer, early rectal cancer

Reprint requests
Toshiki Yamakawa Department of Surgery, Kagawa Prefectural Central Hospital
5-4-16 Ban-cho, Takamatsu, 760-8557 JAPAN

Accepted
February 18, 2009

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