Because this cancer is so rare in children, it can be challenging to diagnose. “For most physicians, the diagnosis of mesothelioma [in children] is low on the list,” Dr. Moran says. Children with mesothelioma tend to complain of the same symptoms: pain, bloating, and fluid build-up in the abdomen. Moran says that it is important to rule out other types of lesions in this location before making an unequivocal diagnosis of mesothelioma in a child.

In this study, all of the children had a biopsy (removing a sample of tissue for examination) to determine the type and severity of their cancer. Diagnosing mesothelioma also typically involves radiological scans of the abdomen, as well as immunohistochemical studies, in which the cells are examined to look for specific cancer markers. “You have to do immunohistochemical tests to make sure you aren’t dealing with another tumor that has metastasized [spread] into the peritoneum,” according to Dr. Moran.

Treating mesothelioma presents another challenge to doctors. No standard therapy exists, even for adults with the disease. Surgery and chemotherapy may be used in adult patients. Similar treatments may be tried in children, but regardless of which treatment is used, the outlook is generally poor.

Currently there is very limited research on peritoneal mesothelioma in children to guide doctors in diagnosis and treatment, and what little research does exist is conflicting. Because this cancer is so rare in children, additional research should be done in adult patients to learn more about this disease, says Dr. Moran. “From adults, we can make more meaningful conclusions, and the results may be applied to the pediatric population,” he says.