Copyright ©2009 Baishideng.
World J Gastrointest Surg. Nov 30, 2009; 1(1): 38-48
Published online Nov 30, 2009. doi: 10.4240/wjgs.v1.i1.38
Table 1 Symptoms and signs of DMPM
Abdominal pain (40%)
Abdominal distension (40%)
Constitutional symptoms, such as weight loss and fever (20%)
Incidental finding (10%)
Ascites (70%)
Abdominal or pelvic mass (30%)
Abdominal wall hernia (10%)
Guarding and rebound tenderness (10%)
Pleural effusion (5%)
Table 2 CT characterization of DMPM
CT characterization of DMPM
Diffuse involvement of all peritoneal surface, rarely with an epicenter
Preponderance of disease in mid-abdomen and pelvic
Presence of serous ascites rather than mucoid
Absence of metastasis, irrespective of the volume of disease
Table 3 Immunostains of diffuse malignant peritoneal mesothelioma and adenocarcinoma
CD15 (LEU-MI)0-1058-100
Table 4 Median survival of DMPM using traditional treatment modalities
AuthorsnMedian survival (mo)
Chailleux et al[4], 198811/167101
Antman et al[5], 198837/180151
Sridhar et al[6], 199213/509.51
Markman et al[7], 1992199
Yates et al[8], 199714/272141
Neumann et al[9], 19997412
Eltabbakh et al[10], 19991512.5
Table 5 Recent updates on cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for DMPM
AuthorsnMedian survival (mo)Survival rates (%)
Yan et al[19], 2006100527864554639
Feldman et al[14], 2003499286775959-
Deraco et al[16], 200649NR88746557-
Brigand et al[17], 2006153669584329-
Loggie et al[18], 200112346060503333
Table 6 Interpretative CT classification of small bowel and small bowel mesentery for DMPM
ClassInterpretative CT classification of small bowel and small bowel mesentery
0No ascites in the region of the small bowel; no evidence of peritoneal tumor present; the jejunal and ileal vessels appear as round and curvilinear densities within the mesenteric fat
IFree ascites only; mesentery is stranded and stratified as the fluid accumulation outlined the small bowel mesentery; small bowel vessels are easily identified within the mesenteric fat
IITumor involvement of small bowel and/or its mesentery; peritoneal surface is thickened and enhanced due to the presence of tumor nodules or plaques; there may be an increased amount of ascites and the mesentery may appear stellate or pleated
IIIIncreased solid tumor involvement and adjacent small bowel loops are matted together in some cuts; small bowel mesenteric vessels are difficult to define due to obliteration of mesenteric fat