Primary omental mesothelioma is a malignant tumour of the mesothelial cells of the omentum, related to asbestos exposure. It is an extremely rare condition that presents both diagnostic and therapeutic challenges. We present a review of the related literature and report on a fatal case of primary omental mesothelioma in a 70 year old man, presenting with a painful abdominal mass. Radiological imaging was not diagnostic but useful in excluding other pathologies. Diagnosis relied on specific immunohistochemical analysis. The difficulty in diagnosis and management and the advanced stage of disease meant that prognosis was very poor. Our patient died within 3 weeks of diagnosis.
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