Malignant peritoneal mesothelioma as a secondary cancer following radiotherapy for cervical cancer: a case report and literature review.

Background: Malignant peritoneal mesothelioma (MPM) as a secondary malignancy following radiotherapy is extremely rare. We report a case of MPM that developed as a secondary malignancy after initial concurrent chemoradiotherapy (CCRT) for cervical cancer.Case Presentation.A 52-year-old woman with no history of asbestos exposure underwent definitive CCRT for stage IIB cervical cancer, as classified by the International Federation of Gynecology and Obstetrics (FIGO) staging system. Over 10 years after initial treatment, she developed ascites. Diagnostic laparoscopy led to a pathological diagnosis of peritoneal mesothelioma. Given the absence of asbestos exposure and her medical history, the tumor was considered a radiation-induced secondary cancer. The patient received two lines of chemotherapy, but her performance status progressively declined, and she was transitioned to best supportive care. She died 1 year and 8 months after the MPM diagnosis. Discussion: This case highlights the importance of long-term surveillance following radiotherapy for cervical cancer. Including this case, only four reports exist of MPM developing as a secondary malignancy following pelvic radiotherapy for cervical cancer. In all cases, patients presented with abdominal symptoms and ascites. The case findings underscore the need for clinicians to consider secondary malignancies such as MPM when ascites is detected during follow-up and to pursue a thorough diagnostic workup.