Malignant Peritoneal Mesothelioma in a 16-Year-Old Girl: Presentation of a Rare Disease Malignes peritoneales Mesotheliom bei einem 16-jährigen Mädchen: Manifestation einer seltenen Erkrankung

Malignant peritoneal mesothelio- ma is extremely rarely seen in young patients. Patient: A 16 year-old girl presented with ap- pendicitis-like acute abdominal pain. Intra-oper- atively, multiple confl uent peritoneal nodules were seen on the entire greater omentum and in the pelvis infi ltrating the uterus and both ovaries. Biopsies were obtained and interpreted as serous ovarian carcinoma. Radical surgical resection and hyperthermic intraperitoneal chemotherapy (HIPEC) with carboplatin was performed and fol- lowed by 2 cycles of carboplatin/paclitaxel. His- tological reevaluation showed characteristic fea- tures of epithelioid peritoneal mesothelioma and ruled out serous ovarian cancer. Therapy was continued with 6 cycles of pemetrexed/cisplatin. Results: 3 months after end of chemotherapy vital tumor tissue was found in the recess behind the liver, which could be resected completely. The patient is currently disease-free 17 months after initial diagnosis. Conclusion: Malignant peritoneal mesothelio- ma in young female patients might be under- recognized and possibly misdiagnosed as ovarian serous carcinoma in some cases. International and interdisciplinary cooperation is necessary in order to provide evidence based guidelines for diagnosis and treatment in the future. Zusammenfassung