Peritoneal mesothelioma is a rare tumor, with difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30–45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report a case of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed.

Case presentation: A 24 years old male patient was admitted with complaints of pain abdomen (on & off) and abdominal distension since 15 days, in the absence of inhalational exposure to asbestos, caused diagnostic confusion. He had history of unresolving hemorrhagic ascites. No drug allergy was noted. Diagnostic laproscopy was done, shows multiple omental nodules. Omental biopsy along with immunohistochemistry leads to diagnosis of malignant peritoneal mesothelioma.

Conclusion: Peritoneal mesotheliomas are rare clinical entities. However, patients with prolonged abdominal pain and ascites should be considered to have atypical pathologies such as peritoneal mesotheliomas.

Khushboo had done MBBS from reputated Government Medical College, ANMMCH, Gaya (Bihar) and pursued DNB Pathology from Medanta- The Medicity, Gurugram, Haryana, one of the best hospitals in the world. Had attended several conferences, workshops and CMEs as speaker and delegates. Was awarded ‘Best Poster Presentation’ at Dapcon, Delhi March, 2019  for the poster titled ‘Dual infections diagnosed on BAL cytology- report of two cases. Worked in Medanta hospital, Ranchi as Associate Consultant. Done observership in Surgical oncopathology from TMH, Mumbai. Had expertise in histopathology (onco), cytopathology, immunohistochemistry. Undergoing Oncopathology 6 months training course in HBCH & MPMMCH, Varanasi (a unit of TMH, Mumbai), Uttar Pradesh, India. Had several publications with more than 8 years of experience.