Benign multicystic peritoneal mesothelioma mimicking mucinous ovarian neoplasm with pseudomyxoma peritonei

Cystic mesothelioma, also known as benign multicystic peritoneal mesothelioma (BMPM), is a rare neoplasm and one of the five main histological types of peritoneal mesothelioma. Although it is usually considered benign histologically, it is increasingly accepted as a ‘borderline malignancy’ because the local recurrence rate is high. It is more common in middle-aged women and is generally asymptomatic. Considering that BMPM is often found in the pelvis, it is difficult to differentiate from other pelvic and abdominal lesions, such as cystic ovarian masses, especially mucinous cystadenoma–adenocarcinoma, pseudomyxoma peritonei, etc. Preoperative diagnosis is very difficult due to its rarity and lack of specific diagnostic imaging and clinical findings. Definitive diagnosis is made only by pathological evaluation. In this article, we aimed to present the imaging findings of a BMPM case in a woman who was diagnosed with mucinous ovarian neoplasm with pseudomyxoma peritonei preoperatively and underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.