1130-0108/2017/109/5/374 REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS REV ESP ENFERM DIG © Copyright 2017. SEPD y © ARÁN EDICIONES, S.L. 2017, Vol. 109, N.º 5, pp. 374 PICTURES IN DIGESTIVE PATHOLOGY Presentation of a malignant peritoneal mesothelioma in the form of rough hepatic calcifications Carmen Lara-Romero, Aida Casado-Bernabéu and Eduardo Romero-Pérez Department of Digestive Diseases. Hospital Universitario Virgen de la Victoria. Málaga, Spain The malignant peritoneal mesothelioma is a strange type of tumor that affects the peritoneal serosa, making up 10% of all mesotheliomas. Similar to the pleural mesothelioma, it is associated with industrial pollutants and asbestos, with a latency period of 30 years from exposure. There are no specific signs or symptoms, and it is usually diagnosed at an advanced stage. The most frequent symptoms are pain and abdominal distension, anorexia and weight loss. The localized form of the disease is less frequent and it usually presents itself as a heterogeneous intra-abdominal mass. CASE REPORT Fig. 2. Abdominal TC. We present the case of a 60-year-old hypertensive male, without any other relevant medical history, who attended the Emergency Unit complaining about abdominal disten- sion and asthenia for the past three months. On examination he presented an ascitic abdomen and what felt like a stony mass in the right hypochondrium. The chest X-ray showed other abnormalities (Fig. 1). The abdominal computed a calcified mass on the right hypochondrium, without any tomography (CT) showed a heterogeneous sub-phrenic mass, with calcifications that involved the right hepatic lobe (Fig. 2). Blood tests and tumor markers including alphafetoprotein were normal. The patient needed diuret- ics adjustments and several evacuative paracentesis during his stay in hospital in order to control the ascites. He had a positron emission tomography (PET) scan that showed a pathologic caption on the apical part of the voluminous tumor, with an important calcification and signs of hepatic infiltration on the right lobe. An exploratory laparoscopy was needed to achieve a histology sample, which finally gave the diagnosis: malignant peritoneal mesothelioma. REFERENCES 1. Teta MJ, Mink PJ, Lau E, et al. US mesothelioma patterns 1973-2002: Indicators of change and insights into background rates. Eur J Cancer Prev 2008;17:525. DOI: 10.1097/CEJ.0b013e3282f0c0a2 2. Boffetta P. Epidemiology of peritoneal mesothelioma: A review. Ann Oncol 2007;18:985. DOI: 10.1093/annonc/mdl345 3. Rodríguez D, Cheung MC, Housri N, et al. Malignant abdominal mesothelioma: Defining the role of surgery. J Surg Oncol 2009;99:51. DOI: 10.1002/jso.21167 4. Estrada Saiz RV1, Loscos Valerio JM, García-Paredes J, et al. The role of laparoscopy in the diagnosis of primary peritoneal mesothelioma. Fig. 1. Abdominal X-ray. Rev Esp Enferm Dig 1995;87(5):403-6..