Clapper, Patti, Schweizer and Mason

Mesothelioma is a rare malignancy of the mesothelium, or lining of most of the internal organs of the body, mostly the lungs, abdomen and heart.  The primary cause of mesothelioma is prior exposure to asbestos.  All types of mesothelioma are rare, with estimates of about 2,500- 3,000 cases in the United States annually.  Primary omental mesothelioma is even more rare.

The most common form of mesothelioma is pleural, beginning in the lining of the lungs, then the peritoneum (lining of the abdomen), and the most rarely in the pericardium (heart) or tunica vaginalis testis.  Very few cases have been reported where the primary malignancy of peritoneal mesothelioma originates in the greater omentum.

Despite improved imaging and ultrasound technology and immunohistochemical analysis, making a differential diagnosis remains difficult.  Often mesothelioma is not diagnosed until it has reached advanced stages, when management of the disease is challenging and prognosis is quite poor, usually less than a year.

Researchers A. Harb and colleagues from Queen Mary’s Hospital, as well as scientists who have studied different forms of mesothelioma, published a report in the Journal of Gastrointestinal Surgery that recommends  primary omental mesothelioma be added as a category for differential diagnosis.