Papillary Mesothelioma

Papillary mesothelioma, known in the medical field as well-differentiated papillary mesothelioma (WDPM), is a rare variant of epithelial mesothelioma. This form of mesothelioma, in contrast with the conventional diffuse malignant mesothelioma (DMM), is considered to be of low malignant potential.

Well-differentiated papillary mesothelioma tumors typically take an indolent clinical course (meaning the disease causes little to no pain and is relatively inactive and benign) and often bear a good prognosis, though occasional cases of a more aggressive nature have been reported. Even in benign instances, high rates of recurrence are relatively common.

The large majority of cases have occurred in women (usually of reproductive age) in the peritoneum, which is the mesothelial lining of the abdominal cavity. A number of WDPM cases have also occurred in the tunica vaginalis of the male reproductive system. Other cases have been reported in the pericardium (the mesothelial lining of the heart), pleura (the mesothelial lining of the lungs), and ovaries as well.

Unlike the conclusive relationship between asbestos and DMM, the majority of WDPM cases have developed in the peritoneum of young females without any known asbestos exposure. However, in a number of studies on WDPM, many patients bore a certifiable history of asbestos exposure, ranging from occupational to secondary to household.

Due to the rare occurrence of this disease, a recommendation of uniform treatment has yet to be established. The typical forms of treatment that have been documented in various studies are similar to traditional mesothelioma treatments and have included surgery and multiple forms of chemotherapy.

Sources:

Butnor, K., Sporn, T., Hammar, S. et al. Well-Differentiated Papillary Mesothelioma. (2001). The American Journal of Surgical Pathology: 1304-1309.
Spano, J., Soria, J., Sabourin J. Well-Differentiated Papillary Mesothelioma (WDPM): Successful therapy by local surgery alone or combined with intraoperative intraperitoneal heated chemotherapy (IPHC) perfusion using cisplatin. (2003). Proceeding of the American Society for Clinical Oncology; 22.
Lovell, F. and Cranston, P. Well-Differentiated Papillary Mesothelioma of the Peritoneum. (1990). American Journal of Roentgenology; 155:66, 1245-1246.
http://www.ajronline.org/cgi/reprint/155/6/1245.pdf
McCaughey, D. Well-Differentiated Papillary Mesothelioma of the Peritoneum: a clinicopathologic study of 22 cases. (1990). Cancer; 65: 292-296.
Hoekstra, A., Riben, M., Frumovitz, M. et al. Well-Differentiated Papillary Mesothelioma of the Peritoneum: a athological analysis and review of the literature. (2005). Gynecologic Oncology; 98(1): 161-167.

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