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Malignant peritoneal mesothelioma: Epidemiology, risk factors, clinical presentation, diagnosis, and staging

H Richard Alexander, Jr, MD
Section Editor
Kenneth K Tanabe, MD
Deputy Editor
Diane MF Savarese, MD


Malignant mesothelioma is a highly lethal malignancy of the serosal membranes of the pleura, peritoneum, pericardium, or tunica vaginalis testes. This is a rare disease. As an example, of the approximately 3300 cases of mesothelioma diagnosed in the United States every year, only 10 to 15 percent are peritoneal [1-4]. The peritoneum is the second most frequent site of origin of mesothelioma, following the pleura. The pathogenesis of all forms of mesothelioma is strongly associated with industrial pollutants, of which asbestos is the principal carcinogen associated with the disease. (See "Epidemiology of malignant pleural mesothelioma", section on 'Asbestos exposure'.)

Malignant peritoneal mesothelioma (MPM) is an understudied disease, largely because most molecular and clinical studies have been conducted predominantly in patients with the more common pleural variant. However, it is not clear that the two diseases are similar. While they share the same predominant risk factor (asbestos exposure), gene expression profiles of pleural and peritoneal mesotheliomas are distinct, suggesting differences in molecular pathogenesis between the two [5,6].

This topic review will cover the epidemiology, histology, clinical features, diagnosis, and staging of MPM. Treatment of MPM and the epidemiology, pathology, clinical presentation, diagnosis, and staging of pleural, pericardial, and testicular mesothelioma are presented elsewhere. (See "Malignant peritoneal mesothelioma: Treatment" and "Epidemiology of malignant pleural mesothelioma" and "Presentation, initial evaluation, and prognosis of malignant pleural mesothelioma" and "Initial management of malignant pleural mesothelioma".)


In the United States, malignant peritoneal mesothelioma (MPM) accounts for approximately 10 to 15 percent of all cases of mesothelioma, and there are approximately 400 new cases diagnosed annually [1,2]. Mesothelioma rates are rising worldwide, largely a reflection of occupational asbestos exposure [1,4,7,8]. The incidence is expected to peak between 2015 and 2025 [9]. However, pleural mesothelioma accounts for most of the rising number of cases. At least in the United States, incidence rates of MPM have remained stable over the last 30 years [4,10]. (See "Epidemiology of malignant pleural mesothelioma".)

In contrast to pleural mesothelioma, which has a male predominance (male to female ratio of between four and five to one), men comprise a smaller proportion of cases of MPM [1,2,4,11].

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Literature review current through: Sep 2017. | This topic last updated: Feb 26, 2016.
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