Primary Mesothelioma of the Liver: A Case Report

Primary hepatic mesotheliomas are very rare with only a few cases reported in the literature. Here we present a 55-year-old female with an 18 cm intrahepatic epithelioid mesothelioma with cystic changes who presented with non-specific abdominal pain and no prior history of exposure to asbestos. The tumor was resected with negative margins. The tumor was composed of islands of relatively monotonous epithelioid cells with extensive cystic degeneration. The nuclei were quite bland, round to oval with frequent grooves and inconspicuous nucleoli and minimal pleomorphism. Tumor necrosis was not seen. No keratinizaton or glandular differentiation was evident. The tumor background consisted of a rich inflammatory cell infiltrate composed of lymphocytes, plasma cells and histiocytes. The tumor was positive for mesothelial markers (calretinin, WT-1 and D2–40), keratins (CK5/6, CK7, CK19) and negative for a variety of other markers to exclude adenocarcinoma and other neoplasms. The patient is well and free of disease 8 years following the surgical resection.