Benign multicystic peritoneal mesothelioma usually occurs in middle-aged women with a history of abdominal surgery. Clinical features at presentation are nonspecific and include nausea, vomiting, abdominal pain, constipation, and a palpable mass. Ultrasound, computed tomography, and magnetic resonance imaging often do not allow differentiation from other cystic or noncystic lesions.6 The use of fine-needle biopsy is unlikely to provide further information because the aspirate usually shows reactive, aspecific mesothelial cells. During surgery, benign multicystic peritoneal mesothelioma appears as a multicystic tumor with translucent cysts filled with gelatinous fluid and separated by fibrous septa. On histopathologic examination, cysts are lined with single or multiple layers of cuboidal cells that are immunoreactive for epithelial antigens.7 Nonoperative management with close follow-up in asymptomatic patients with benign multicystic peritoneal mesothelioma is considered a valid alternative to surgical resection, although, given the difficulties in the preoperative diagnosis, the usual practice is surgical exploration with total excision for localized lesions. Laparoscopic treatment has also been described in the literature.8 Despite a recurrence rate ranging between 25% and 50%, the benign characteristics of benign multicystic peritoneal mesothelioma make adjuvant chemoradiotherapy and heated intraoperative intraperitoneal chemotherapy of no use—although both are still recommended in some reports.9- 10 All authors do agree, however, that close postoperative follow-up with ultrasound or computed tomographic scans is recommended.