Malignant peritoneal mesothelioma is rare form of cancer that affects the peritoneum, which is the lining of the abdomen. Every year, around 100-500 new cases are seen in the United States. It is also known as abdominal mesothelioma as the peritoneum protects and lines the abdominal cavity and the organs situated in the abdominal cavity. There are two layers of the peritoneal membrane called visceral and parietal layers. The visceral refers to the inner layer covering of the organs and the parietal refers to the outer layer covering of the abdominal cavity.



The peritoneal membrane cells attacked by mesothelioma normally secrete lubricating fluids into the peritoneum, this allows for frictionless smooth movements of the organs in the abdominal cavity. However when these cells are transformed into cancerous abnormal cells, they start to over secrete this fluid leading to a gradual fluid build up in the abdomen.

Abdominal Mesothelioma is usually secondary to a primary source of the malignancy, which is Pleural mesothelioma. It is believed that the asbestos fibers may be ingested when swallowed, where they enter digestive tract or that the fibers are inhaled into the lungs and transported via the lymphatic system to the abdominal cavity. Cancer cells from the primary source can also become mobile and spread via the lymphatic system to other areas, this process is called metastasis.

Symptoms of peritoneal mesothelioma include:

- Abdominal pain,

- Swelling of the abdomen which may be caused by fluid retention (ascites)

- Tumor growth into the intestine causing small or large bowel obstruction

- Anemia-low blood level, which causes decreased oxygen levels in the blood, and makes the heart work harder, also causing shortness of breath

- Weight loss, but you may appear larger around the waist

- Fever.

If you have been exposed to asbestos in your lifetime and you are having any of these symptoms, you should see your doctor immediately.

Relatives of the mesothelioma victim are also at risk of developing the cancer. Spouses who handled dirty clothes to launder them are at risk to having asbestos transferred to them via physical contact with the fibers. Now that more is known about asbestos, workers must bathe and change clothes before going home. Special care is taken to limit exposure to the asbestos fibers.

Diagnosis of peritoneal mesothelioma is similar to that of pleural mesothelioma. An x-ray will be taken. Mesothelioma cannot be seen on an x-ray, but a tumor may cause pleural effusion (fluid buildup) which can be seen. The doctor may also order a CT scan or an MRI to back up and add to the findings in the x-ray. Once the scans are done, a biopsy must be done to examine to tissue. The doctor will make a cut through the chest wall; this procedure is called a thorascopy. This will be done in the hospital under local anesthesia.

The doctor may also perform a peritoneoscopy, which involves surgically inserting a scope into the abdomen to visualize the tumor cells and take tissue samples for biopsy. The procedure is similar for both thoracic and abdominal examinations. Samples of tissue obtained will be examined by the pathologist under the microscope.

Mesothelioma is quite rare, so if you are diagnosed with it, you should have your doctor help you find a specialist who is well versed and experienced in the treatment of the disease and there are not too many of such specialists. There is no cure for malignant mesothelioma, but there are treatment options that include surgery, radiation, chemotherapy, and others. The life expectancy of someone with malignant peritoneal mesothelioma varies from person to person. The prognosis depends on how vigorously the cancer is treated and how the patient responds. The patient may live for years, or only for a few months.