HISTORY AND CLINICAL FINDINGS: A 56-year-old @entity1 (case 1) with recurrent @entity548 for one year was admitted to our hospital for further investigation. Besides massive ascites he did not show abnormal physical signs. In addition, two 45-year-old @entity1 were admitted (case 2 and 3) with clinical signs of acute abdomen--one having muscular guarding in the epigastric angle, the other in the right lower quadrant. All 3 @entity1 did not have serious illnesses in the past; the first 2 @entity1 had occupational asbestos exposure. INVESTIGATIONS: In @entity1 1 the ultrasound did not reveal abnormal findings besides ascites. @entity1 2 and 3 underwent explorative laparotomy. DIAGNOSIS, TREATMENT AND COURSE: In the first case a diagnostic laparoscopy revealed @entity5 proliferations with nodular formations over the entire peritoneum--histologically a @entity3620 of the epithelial subtype. @entity1 2 showed intraoperatively metastatic spread of @entity5 formations with infiltration of the peritoneum and transverse mesocolon. The histologic finding was similar to that in the first case. @entity1 3 had a perforated sigma @entity4436 which was treated by resection of the sigmoid. Incidentally a well differentiated @entity298 was found in the resected specimen. The first two @entity1 were treated with alpha-interferon subcutaneously resulting in a decrease of ascites production. Because @entity1 3 showed neither ascites nor evidence for malignancy no interferon was administered. CONCLUSION: In case of @entity548 of unknown cause a histological clarification by either laparoscopy or laparotomy is mandatory. Immunomodulation with interferon may be a promising approach.

[A rare cause of XXXX ].

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhagic ascites'] @entity5 :: ('MESH:D009369', 'Disease') :: ['diffuse tumor', 'tumour'] @entity3620 :: ('MESH:C562839', 'Disease') :: ['malignant peritoneal mesothelioma'] @entity4436 :: ('MESH:D004238', 'Disease') :: ['diverticulitis'] @entity298 :: ('MESH:D010538', 'Disease') :: ['papillary peritoneal mesothelioma']
@entity3620 :: (MESH:C562839,Disease) :: ['malignant ascites--peritoneal mesothelioma']
