Laparoscopy and primary diffuse malignant peritoneal mesothelioma: a diagnostic challenge

Primary diffuse malignant peritoneal mesothelioma is a rare malignancy with an estimated incidence of 200 to 400 new cases annually in the USA. We describe a case of diffuse malignant peritoneal mesothelioma arising in a 65-year old man who presented ascites of unknown origin. The importance of laparoscopy with subsequent histology of biopsy specimens in the diagnosis of this disease is emphasized. Because of his poor general condition, the patient had no further treatment. Update of treatment is briefly described with particular attention to multimodality approach.