Tumors of the Mesentery and Peritoneum

Benign Tumors

Benign tumors of the mesentery and peritoneum are twice as common as malignant tumors; however, they are still rare. The most common benign tumors are fibromas and lipomas. These tumors often grow large before causing symptoms and are most often found incidentally during routine examination. The most common symptoms are vague abdominal pain and bloating caused by compression or traction of adjacent structures. Intestinal obstruction may occur.

Diagnosis is usually made by x-rays that reveal extrinsic compression of the large or small bowel. Surgical excision is curative.

Malignant Tumors

Malignant tumors of the mesentery and peritoneum, which are rare, include mesothelioma (related to asbestos exposure), fibrosarcoma, and leiomyosarcoma. Symptoms and signs include vague abdominal pain and bloating caused by traction or compression of adjacent structures and intestinal obstruction. Weight loss, anorexia, and weakness can also occur. Patients with mesothelioma have chylous ascites.

Diagnosis is made with an upper GI series, barium enema, and CT, which in combination reveal extrinsic compression or signs of invasion of the small or large bowel and other local structures. Surgery is the only effective treatment for either cure or palliation. However, chemotherapy and radiation therapy may improve results for mesothelioma.