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Pronunciation tips for presenters

The following page intends to give some useful tips and advice on improving pronunciation whilst giving a presentation.

Get physical

Do some 'warm-ups' to loosen up your mouth and your tongue before you speak. You can move and stretch your mouth, and repeat tricky words and sounds. Doing this will help you to overcome the physical 'stiffness' of the articulators and to speak fluently and clearly.

Get interested in your talk

Focus on your content. Make it sound interesting for your audience. If you speak with meaning and commitment along with healthy interest in the subject you tend to lose your nerves. Ensure you speak clearly so that your pronunciation can be understood.

Give your audience time to take in what you are saying

You can do this by pausing at the end of word groups and information chunks. Pausing is important for listeners because they need time to absorb information. Pausing also gives you, the presenter, time and 'space' to stress key words and use intonation signals.

However, too much pausing, or stopping at the end of each word or couple of words can make you sound hesitant and lacking in confidence. It also makes every word carry too much meaning. English speakers get meaning across by stressing key words in information chunks.

Give your audience a sense of direction

Don't lose your audience in a forest of words. A presentation is like a journey. Take your audience with you.

Signal new topics and sections of your presentation by:

  • starting on a higher pitch level
  • stressing the key words, such as signposting words and the topic word/s of your new section.

Let your audience know when information is finished or not by using:

Let your audience know what's important

Present key information clearly by stressing key words. In English, new information usually occurs towards the end of a speech chunk or sentence. Keep your voice and breath going so you can stress those crucial words at the end.

Get the basics right

Make sure that you can pronounce key vocabulary, data, names and acronyms clearly and accurately. To do this:

  • check the stress in poly-syllabic (multi-syllabic) words - use a dictionary or ask a competent English speaker if you are not sure. Practice difficult vocabulary.
  • identify and practise problem sounds, particularly in high frequency words and key words in your presentation.

Rehearse and reflect

Nothing beats practice. It is amazing what mistakes you will find in a presentation as soon as you start rehearsing.

Practise your presentation standing up and imagine yourself in the situation.

  • Your opening. When you start your presentation, you're likely to feel nervous so it is helpful to know exactly what you are going to say to open your presentation, where you will pause, what words you will stress, and the intonation you will use.
  • Topic sentences and signposting words introducing new topics or making a topic change. This will make your transitions smooth and easy to follow.
  • Your conclusion and the body of your presentation, including how you will refer to any visual aids as you move through your presentation.

Video or record yourself if possible and use a checklist to evaluate how effective you are. Better still, get someone to listen to you and give you some feedback.

Back to top

UTS acknowledges the Gadigal people of the Eora Nation, the Boorooberongal people of the Dharug Nation, the Bidiagal people and the Gamaygal people, upon whose ancestral lands our university stands. We would also like to pay respect to the Elders both past and present, acknowledging them as the traditional custodians of knowledge for these lands.

presentation pronunciation australia

Macquarie Community College

  • Total: $ 0.00

presentation pronunciation australia

Australian Spoken English and Pronunciation – Advanced

Accredited units.

  • ( SWEELD001 ) Engage in and listen to basic spoken dialogues

Non-accredited units

  • ( CSO202081 ) Pronunciation for informal exchanges
  • ( CSO202015 ) Received Pronunciation – Advanced
  • ( CSO202104 ) Pronunciation for presentations

Course Overview

Do you need to improve your Spoken English for work and study?

Macquarie Community College is a leading provider of English teaching, offering you an inclusive and supportive environment in which to learn. Our English course is designed to enhance your workplace communication skills and refine your everyday Australian pronunciation.

If you find yourself shying away from speaking in formal or informal situations because you lack confidence in pronunciation this course is for you. Join the class for a fun and interactive experience whilst learning key language skills.

The Australian Spoken English and Pronunciation – Advanced level is designed for people who have mastered fluency in speaking English but sometimes struggle to understand Australian pronunciation, idioms and slang. Whilst there are many variations of the Australian accent, our course has a focus on mastering the standard Australian accent commonly heard in Sydney city.

Learn how to use and understand typical Australian phrases in a supportive and encouraging environment and so that you can present yourself with more confidence at work or social situations.

The Australian Spoken English and Pronunciation – Advanced course is suitable for people who:

  • Have a slight foreign accent
  • Are not familiar with a range of Australian vowel sounds
  • Want to further explore symbols that are used as phonemic transcription of Australian English

At this Advanced level, you will learn about complex rules and patterns of Australian English pronunciation. Your lessons will concentrate on practical workplace conversations that incorporate Australian idioms and routine presentation done in standard Australian accent.

Discover the art of sentence stress, speech connection, and effective use of intonation. Our expert guidance will assist you in reducing your accent and identifying key areas for improvement. We’ll equip you with the skills to comprehend and communicate effectively in everyday conversations and workplace scenarios, ensuring you can better grasp what Australians are saying.

Macquarie Community College operates from a range of venues across Northern and Western Sydney. We have campuses in Blacktown, Carlingford, Chatswood, Epping, Mt Druitt, Richmond and Ryde. Enrol now!

Learn more about this course

What you will learn

Course outline.

In this Australian Spoken English and Pronunciation – Advanced course you will learn:

  • Complex rules and patterns of Australian pronunciation
  • Australian vowel and consonants
  • Australian Phonetics
  • An extensive range of Australian idioms
  • Variety of Australian slang
  • Australian sentence stress
  • Australian intonation

Course outcome

By the end of the course you will have mastered having a conversation whilst fine tuning your best Australian accent. You will be more familiar with common Australian slang and idioms. You will be more confident in speaking with and understanding Australians in everyday situations.

At the end of the course, you will be issued a Statement of Attainment for the units where competency has been achieved.

What is involved

Time commitment.

The course will encompass online ZOOM sessions in addition to self-paced home study.

Assessment (including recognition of prior learning) must:

  • Meet the requirements of the relevant unit of competency, training package or accredited course, and
  • Be conducted in accordance with the principles of assessment and the rules of evidence, and
  • Meet workplace and, where relevant, regulatory requirements.

For this course assessment will entail the following:

  • Assessment methods include written and oral tasks, practical tasks and observation by the assessor. You will be informed when assessments are to take place.

What you need to know

Entry requirements.

An appropriate level of Language, Literacy and Numeracy (LLN) skills are required to enrol in this course. Macquarie Community College may conduct an LLN assessment as part of the pre enrolment process.

Students in this course will be required to have English communication skills at the upper intermediate level or above.

What you need to provide

  • All course material is provided and inclusive with course fees
  • Notepad and pen

Fees and government subsidies

The NSW Government’s Adult and Community Education (ACE) Program provides affordable, local training and education to NSW communities. Under the ACE program, participants, employers, delivery partners and providers and the government collaborate to improve learning outcomes for learners and meet community training needs. The ACE Program will also offer support to small business owners and their staff by providing fully subsidised accredited and non-accredited training in targeted courses in information technology, business services or foundation skills. *Eligibility criteria apply. This training is fully subsidised by the NSW Government, and as a result your fee is determined through Training Services NSW formal eligibility criteria. Students will need to supply the required evidence in accord with the requirements of Smart and Skilled eligibility.

  • Eligible for Subsidised Training: Fee-Free
  • Not Eligible for Subsidised Training: Price on Application

If you're a prospective student, employer or service provider please visit: https://www.macquarie.nsw.edu.au/adult-and-community-education/ for more information where you will find everything you need to know about the ACE program before you enrol. Contact us today or call on 1300 845 888 to check your eligibility.

What you can do next

Study pathway.

After completing this study, you can complete FSK20119 Certificate II Skills for Vocational Pathways.

Class details

RTO 90033

  • FEES & GOVERNMENT SUBSIDIES
  • CREDIT TRANSFER
  • RECOGNITION OF PRIOR LEARNING
  • DELIVERY MODE

Fees & Government Subsidies

At Macquarie Community College, we create and provide affordable and inclusive learning opportunities that meet the needs of individuals, organisations and communities.

Given the broad range of accredited and non-accredited programs offered by the College the fees and subsidies will vary depending on the course.

Fee for Service Courses 

Courses available on a fee-for-service basis will have the price clearly indicated within the class details. Additional fee information may also be found in the ‘’what you need to provide’’ section of the course details.

Funded Courses

Macquarie Community College delivers NSW government subsidised training, including training under the Smart and Skilled and Adult and Community Education (ACE) programs.

To access government subsidised training, including fee exemptions or concessions, you must meet the following criteria:

  • aged 15 years or older
  • no longer be at school
  • living or working in NSW
  • Australian OR New Zealand Citizen, Australian Permanent Resident OR a Humanitarian Visa Holder, OR a Partner Visa Holder whose sponsor is a current or past Humanitarian Visa Holder

When you enrol in a NSW government subsidised course you will be required to pay the Smart and Skilled student fee unless you qualify for a fee exemption.

For further information on NSW government subsidies visit the below funding pages.

Adult and Community Education 

Smart and Skilled 

Traineeships

NSW Fee Free Training 

Credit Transfer

Am I Eligible for Credit Transfers?

Credit Transfer (CT) is granted as a result of identifying learning outcomes already achieved through formal training. Credit outcomes may allow for entry into a qualification and/or provide credit towards the qualification. Credit Transfer given may reduce the time required for you to achieve the qualification.

To apply for Credit Transfer you will need to provide original or certified copies of certificates previously attained through formal training prior to completing the enrolment process.

Recognition of Prior Learning

Recognition of Prior Learning (RPL) is granted as a result of identifying and assessing previous and current informal education and training, work experience and/or life experience and knowledge. Previous learning and the evidence supplied is measured against pre-determined performance standards contained within the Units of Competency.

To apply for recognition of prior learning you should indicate your decision to apply for recognition as soon as possible after enrolment and the induction program.

We will be happy to provide you with an RPL kit after speaking directly with you to ensure you understand the requirements of this process.

Delivery Mode

To meet the needs of our students Macquarie Community College balances delivery and engagement across permanent, regular and temporary delivery sites and offer face-to-face, remote zoom classes and self-paced learning options.

Ways to Study

Our college campus locations are:

  • Carlingford
  • Virtual classroom
  • Complete workplace training
  • Combine ways to study

How you got questions? Please see our comprehensive FAQ page for everything you need to know about Macquarie Community College, our policies, student support, application and enrolment procedures.

How to Apply

Step 1 - Apply

  • Select your preferred course and class
  • Review course and fee subsidy requirements to check your eligibility
  • If you need help contact us via livechat or via contact us form
  • Click Apply now

Step 2 - Assessment / Enrolment

  • We will assess your application and make contact within 2 business days
  • You will be asked to complete a language, literacy & numeracy assessment
  • Complete enrolment form
  • Provide all required evidence and/or documents

Step 3 - Start Learning

Following submitting your enrolment form and documents you will receive:

  • An enrolment confirmation
  • Tax invoice / payment plan details (if relevant)
  • A course reminder prior to your classes starting
  • A Zoom link (Online Zoom classes only)
  • A student login to your learning portal if relevant

Presentation - pronunciation: audio and phonetic transcription

Presentation, american english:, [ˌpɹɛzn̩ˈteɪʃən] ipa, /prezntayshuhn/ phonetic spelling.

presentation pronunciation australia

British English:

[ˌprezənˈteɪʃən] ipa, /prezuhntayshuhn/ phonetic spelling.

presentation pronunciation australia

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IPA : prez(ə)nˈteɪʃn

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p-resent-a-tion 0 rating rating ratings Marcos McClure p-re-sen-ta-tion 0 rating rating ratings Private pre-sen-ta-tion 0 rating rating ratings Gerrit Mabaso prez-uh n-tey-shuh n 0 rating rating ratings Fredy Willms

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Australian English: Examples, Accent, Pronunciation, Words

Australian English is a bundle term for the varieties of English language spoken by the people of Australia. English is de facto national language of Australia as it is the only language spoken at home by 72% of the population. It is also the language of legislature and courts. The medium for compulsory education in Australia is also English.

Australian English is primarily based on British English but over the years it has developed its own unique style, sound, vocabulary, and slang. The linguists consider it as a mixture of standard British English and standard American English . In this write-up, we are discussing features of Australian English and how it is different from other forms of Standard English.

What is Australian English?

Australian English is the version of the English language spoken by the people of Australia. It is the first language of the majority of the Australian population.

English was introduced to Australia by the British – hence originally the language spoken in the country was based on British English.

In 1788, British ships brought British convicts to Australia and established the Colony of New South Wales. The convicts came from different regions and had different dialects. When all these people with different dialects started living together, a new and unique accent emerged. This unique accent developed over the years is now called Australian English.

An interesting fact about Australian English is that the accent is almost similar throughout Australia. The differences in the accent are very subtle and they are typically associated with the socioeconomic status of the speaker.

The Australian English spoken in Australia is generally seen as a hybrid variety of British English and American English. But, these aren’t the only languages to contribute to the richness of Australian English. It is influenced by Irish, Chinese, and various Aboriginal languages too.

What Makes Australian English Unique?

Till now we discussed Australian English is different from other varieties of English. Let us now see the characteristics that make it different from other varieties of English.

Use of diminutives or shortened versions

One of the distinguishing features of Australian English is that it uses shortened versions of standard English words much more than any other form of English. These shortened forms, also called diminutives, sometimes make Australian English so different that English speakers from other countries might struggle to even get the context of the conversation.  For example,

  • Barbie for Barbeque
  • Defo / Defs for Definitely
  • Sunnies for Sunglasses
  • Smoko for Cigarette or a Cigarette break
  • Sanga for Sandwich
  • Arvo for Afternoon
  • Mozzie for Mosquito

Unique Spelling Conventions

Australian English uses unique spelling conventions that neither totally align with British English nor with the American English. For example,

  • In words like ‘colour’ and ‘flavour’ Australian English uses British English spelling but for words like ‘defense’, it uses American English spelling.
  • Words, like ‘realise’ and ‘organise’, are spelt in the British style whereas words like ‘yogurt’ are spelt in the American way.
  • In some words like ‘media’, Australia has unique grammar rules. It uses ‘media’ as singular and ‘medias’ as plural.

Idioms and other figurative speeches

Australians do have some unique phrases and idioms that are not known to speakers of other varieties of English. For examples,

  • Good on ya! – Expression used for well done or congratulations
  • Fair dinkum – It means genuine, true, or honest
  • Barrack for – support or cheer a team; somewhat similar to ‘root for’
  • Chock-a-block – crowded
  • Up a gum tree – stuck in a difficult or tricky situation
  • Flat out like a lizard drinking – Very busy or working at a fast pace
  • Go off like a frog in a sock – to go crazy

Unique Pronunciation

Australian English has some really interesting features that make it sound way different than any other varieties of English. For example,

  • R at the end of a word is not pronounced. Car sounds like ‘cah’. Jar sounds like ‘jah’.
  • G at the end of a word is not pronounced. Dancing is dancin and going is goin in Australian pronunciation.
  • I in words like sit is pronounced as ‘ee’ making it sound ‘seet’ instead of sit.
  • ‘th’ sound is replaced by ‘f’ or ‘v’. Think may sound ‘fink’ and both become ‘bof’.
  • Australians typically use rising intonation at the end of the sentence making it sound like a question rather than a statement.

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Australian Text To Speech

Easily convert text to speech in Australian English, and 90 more languages. Try our Australian English text to speech free online. No registration required. Create Audio

Australian accent generator text to speech voices can help you easily create voiceovers and narration for the Australian market, or as an Australian accent translator for your content. Text to voice Australian accent voice converters are realistic and life-like, so you can quickly create Australian voice overs, Australian English audio files (MP3/M4A/Wav), and Australian accent videos.

Narakeet has 24 Australian English text to speech male and female voices, and many more in other regional English variants . Play the video below (with sound) for a quick demo.

Australian Accent Voice

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For more options (uploading Word documents, voice speed/volume controls, working with Powerpoint files or Markdown scripts), check out our Tools .

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For more regional English text-to-speech variants, check out the following pages:

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Australian accent text to speech voices can help you quickly record Australian voice over and Australian accent audio much faster than hiring Australian voice talent, and easier than recording the audio yourself. Here are some types of audio and video content you can create easily with {{site.title}} Australian accent voice generators:

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Australian Accent Text to Speech

Convert text to speech Australian accent content quickly and easily using our web site, or automate Australian English text to speech content using our API. Translate to Australian accent your Word documents or PowerPoint files. Use Narakeet as an Australian accent simulator for your content experiments and prototyping, or as an Australian accent pronunciation generator for your media assets.

Narakeet helps you create text to speech voiceovers , turn Powerpoint presentations and Markdown scripts into engaging videos. It is under active development, so things change frequently. Keep up to date: RSS , Slack , Twitter , YouTube , Facebook , Instagram , TikTok

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welcome to aussie english with amanda

Learn Aussie English with Amanda | Australian Slang & Accent

Mar 12, 2024

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Unlock the Secrets of Aussie English with Amanda! Master in Learning Australian English Slang to Perfect Your Pronunciation & Grab the True Australian Accent. For more, visit here: www.aussieenglishwithamanda.com

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WELCOME TO AUSSIE ENGLISH WITH AMANDA Your Certified Guide to Mastering Australian English www.aussieenglishwithamanda.com

G’DAY, I’M AMANDA! • The passionate educator behind 'Aussie English With Amanda’ and I bring a wealth of experience to teaching English as a Second Language. I am Level 5 TEFL Diploma certified and I have been teaching English online, focusing specifically on Australian English, since 2020. • During this time, I've conducted over 8,500 online classes, helping students worldwide immerse themselves in our unique dialect. • My main aim is to assist you in enhancing every aspect of Australian English, from mastering the accent and slang to understanding its history and culture all while empowering you to succeed in your learning journey.

LEARN MORE LEARN MORE LEARN MORE • WORK WITH ME • The ideal choice if you want a personalised plan that is tailored to your language learning goals. • Perfect for the people who want a more social and interactive learning environment. • Coming soon

1:1 PRIVATE CLASSES • My teaching approach is centered around flexibility, even though I provide a range of structured curricula and courses (as listed below). You're not obligated to follow a specific course to engage in lessons with me. Whether you're interested in casual conversation to enhance your fluency or need assistance in refining your writing, I'm here to support your individual learning objectives. Tailoring my approach to fit your unique needs and preferences ensures that our sessions are both effective and enjoyable.

GROUP CLASSES • OPEN CONVERSATION: ENGLISH PRACTICE • EXPLORING AUSTRALIAN ENGLISH AND CULTURE - 10 WEEK GROUP COURSE • AUSSIE ENGLISH CONVERSATIONS UNLEASHED - 6 WEEK SPEAKING CLUB • AUSTRALIAN ENGLISH PRONUNCIATION ESSENTIALS - 6 WEEK INTENSIVE GROUP COURSE

ONLINE COURSES (COMING SOON)

Thank You +61411859398 @aussie.english.with.amanda [email protected] www.aussieenglishwithamanda.com

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Bestiality references allegedly made during presentation at Renmark High School

A sign that says "Renmark High School" above an LED screen with some school news.

Warning for readers: This article contains graphic language.

The South Australian Department for Education is investigating a presentation delivered to year 9 girls in a regional high school that allegedly referenced bestiality as being accepted by the LGBTQIA+ community.

Female students said teachers at Renmark High School told them to leave their lessons and attend a presentation in a separate classroom.

Students who attended the presentation on March 22 say two staff from the Headspace centre in the neighbouring town of Berri introduced a "third-party" presenter who facilitated an hour-long presentation focused on relationships.

Parents said they were not notified about the presentation, nor was it consented to.

Students said they were left unsupervised for the duration of the presentation.

Student Courtney White, 14, said she felt confused and blindsided by the presentation.

"We had a teacher that told us to grab a chair and sit in front of the board, and then the Headspace people came in and then [the teacher] left, so then we're sitting in front of a board alone with no teachers, just the Headspace people," she said.

"The first slide of the PowerPoint on the board was 'You can see queerly now' and 'No point hiding.'"

A mother wraps her arms around her daughter. Both look solemn.

Girls felt 'really uncomfortable'

Fourteen-year-old Emelia Wundenberg said the presenter was graphic when referencing their own sexual preferences and spoke in sexually explicit terms about growing up and being confused about whether they idolised people of the same gender or wanted to be intimate with them.

Students say they were then given an explanation of the initialism LGBTQIA+, with each word and its meaning displayed on the screen.

"There was a slide for what the 'plus' means, and they just started randomly saying words that no-one knew, like bestiality," Emelia said.

"It was on the board when they were showing what the 'plus' meant."

The students said bestiality was then explained in detail and the presenter seemed to imply it was something practised by people who identified as LGBTQIA+.

"They said [the queer community] just accepts all of it, even though … isn't it illegal?" Emelia said.

As the talk went on multiple girls, including Courtney, began to feel uncomfortable and asked to leave the classroom to "go to the bathroom".

"We're all just sitting there like, 'What the hell? What are we doing here? Why are we learning about animals having sex with humans?'" she said.

"It was really disgusting, it was really uncomfortable."

Emelia said many of those who asked to leave the classroom did not return.

When the ABC sought comment from the presenter a response was sent on the person's behalf asking that reporters refrained from reaching out or naming them in its coverage.

A small, dark-coloured building bearing the lettering "Renmark High School Administration".

'Normal procedure' not followed

Letters seen by the ABC that were sent to parents on behalf of Renmark High School principal Mat Evans stated that the presentation was meant to discuss "respectful relationships".

The letter acknowledged that the school's "normal procedure for notifying parents ahead of specific presentations was not followed".

Mr Evans said the third-party presenter had "been suspended from department schools while the department undertakes an investigation".

"We are undertaking an internal review to ensure that processes around such notifications and procedures with regard to third parties attending at our school are always met," he said.

The ABC contacted the Department for Education, which provided a similar statement and said the presentation was being investigated.

SA education department chief executive Martin Westwell said the presentation was "unacceptable" and "shouldn't have happened".

Speaking with ABC Radio Adelaide on Thursday, Professor Westwell said conversations about sexual health, societal norms, stereotypes and sexuality were normal parts of the Australian curriculum, but the presentation at Renmark High School was not.

"The core idea that students should understand sexuality and other sexualities is, I think, really important — but the way [the presenter] went about it was unacceptable," he said.

"The school has clearly made some mistakes.

"There should have been a teacher in the room when that occurred, but there wasn't and the principal has apologised for that.

"They hadn't reviewed the content.

"There was a few things that went wrong and it ended up with this inappropriate language and a few things being discussed in that session that were just not appropriate."

Support being provided to students

Headspace's national head of clinical leadership Nicola Palfrey said the organisation was aware of concerns raised by members of the Renmark community.

"We take all feedback very seriously and are reviewing how we can support and guide Headspace centres … to ensure presentations they facilitate or deliver are aligned with evidence and best practice and are safe and appropriate for young people," she said.

FocusOne Health Board chair Ian Gartley said the "focus at Headspace Berri, operated under licence by FocusOne Health, is on the mental health and wellbeing of young people".

"We are aware of concerns raised by local members of the Renmark community following a presentation delivered by a lived experience speaker that Headspace Berri facilitated at Renmark High School," he said.

"Our priority right now is ensuring that any young people and their families who may be experiencing distress receive the support they need."

All parties involved in the alleged incident declined to provide the presentation to the ABC.

Following the presentation, a follow-up letter seen by the ABC was sent to parents offering counselling services from the education department, which had arranged a social worker to attend the school to help support affected students.

A teenager and her mother, both dark-haired, stand outside, looking solemn.

Parents express shock and outrage

Parents of students who attended the presentation said it was a poor representation of the queer community and had raised many concerns about the school's protocols for third-party presentations.

"Who vetted this material? Who made sure it was safe for 14- and 15-year-old girls? Some of them are still 13," Emelia's mother Kristy Fyfe said.

"It has done a huge disservice to the [queer] community."

Following the presentation, Courtney's mother Nicki Gaylard removed her three children from Renmark High School. 

"My kids are in limbo," she said.

"They're not in an education department at this point.

"I'm not putting them anywhere until I know this won't happen again.

"Under no circumstances should a child in that school ever feel trapped and unsafe without someone with their certificate, meaning a teacher."

The ABC has spoken to five other parents whose children attended the presentation.

They substantiated the two girls' claims.

Two people with short dark hair smiling. They are both wearing dark T-shirts that says "Let's Talk About X".

LGBTQIA+ educators condemn 'slur'

Sexuality educators and LGBTQIA+ inclusion advocates Mel Brush and Eleonora Bertsa-Fuchs conduct consent and queer inclusion training for schools, parents and workplaces via their social enterprise Let's Talk About X.

Both are secondary teachers and Mx Bertsa-Fuchs said queer education was important but should be delivered in a safe and appropriate setting.

"The teachers are the people that these young people have a relationship with, that they are familiar with, that they're comfortable with," Mx Bertsa-Fuchs said.

"When you're in a vulnerable situation, like a respectful relationships workshop or seminar, there should be someone in the room that you are familiar with."

Mx Brush said the alleged use of the word bestiality in the presentation was damaging to the queer community.

"It's pretty shocking to think about that term being thrown around like that, especially given how loaded it is, and for a historical context of the way that it's been used as a slur and to discriminate against LGBT+ people," Mx Brush said.

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Case report article, malignant peritoneal mesothelioma presenting with bilateral hydronephrosis and renal insufficiency: a case report and literature review.

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  • 1 Department of Urology, Guiqian International General Hospital, Guiyang, China
  • 2 Department of Pathology, Guiqian International General Hospital, Guiyang, China

Introduction: Malignant peritoneal mesothelioma (MPM) is an extremely rare tumor with nonspecific clinical manifestations, making diagnosis challenging.

Case presentation: Herein, we report a case of MPM with occult onset presenting with bilateral hydronephrosis and renal insufficiency. A 30-year-old man was admitted to the Urology Department because of recurrent bilateral lower back pain. The etiology was unclear after a series of laboratory tests, imaging examinations, bone marrow aspiration, renal puncture biopsy, ascites examination, ureteroscopy, and so on. Finally, MPM was diagnosed by laparoscopic exploration and biopsy. Moreover, during the course of the disease, the patient's bilateral ureters were compressed, and the obstruction could not be relieved after the placement of ordinary ureteral stents. Percutaneous nephrostomy or metal ureteral stenosis was appropriate in managing malignant ureteral obstruction as it could improve renal function.

Conclusions: The onset of this case was insidious, and the diagnosis was difficult, with a poor prognosis. To date, only a handful of cases have been reported. We hope this case can provide some enlightenment for our clinical work.

Introduction

Malignant peritoneal mesothelioma (MPM) is an aggressive neoplasm that can rapidly spread within the abdominal area. Patients with peritoneal mesothelioma usually present with an abdominal mass, ascites, and abdominal pain. Herein, we report a case with bilateral hydronephrosis and renal insufficiency as the first symptoms. The case was extremely challenging to diagnose, which was finally confirmed based on laparoscopic exploration and biopsy. This study aimed to provide clinical evidence for the diagnosis, treatment, and prognosis of rare MPM.

Case presentation

A 30-year-old man was admitted to the Urology Department because of repeated bilateral lower back pain for 3 months. At the onset of the illness, computed tomography (CT) scans revealed bilateral hydronephrosis, and the serum creatinine (SCr) level was 123 μmol/L. Symptoms improved after the placement of bilateral ureteral stents. However, the back pain recurred 1 month later, accompanied by abdominal distension, nausea, and vomiting. Enhanced CT scans revealed bilateral hydronephrosis, splenomegaly, and ascites. Hydronephrosis had aggravated, with SCr levels increasing to 305 µmol/L. A transurethral cystoscopy revealed no lower urinary tract obstruction. Ureteroscopy indicated narrowing of the lower part of the bilateral ureter, approximately 6 cm from the ureteral opening. During hospitalization, the patient's condition continued to deteriorate, with a progressive decrease in urine volume. The highest SCr level was 470 μmol/L. A plain CT scan revealed bilateral hydronephrosis, splenomegaly, abdominal effusion, peritoneal thickening with exudative changes, and intestinal wall thickening, with no significant mass observed. We performed a bilateral percutaneous nephrostomy (PCN) and abdominal catheterization. Ascites analysis revealed no definite malignant cells. Serum IgG4 level testing yielded negative results. A renal needle biopsy indicated moderate to severe chronic tubulointerstitial injury. Finally, laparoscopic exploration was performed, and intraoperative findings revealed numerous small, shiny, whitish nodules carpeting all visualized peritoneal surfaces and some parts of the intestinal tubes. The tumor infiltrated the entire omentum, forming a large, firm mass ( Figure 1 ). A biopsy of the omentum itself confirmed the diagnosis of peritoneal mesothelioma. Histological findings revealed fibrous tissue hyperplasia with inflammatory cell infiltration and papillary hyperplasia of the overlying mesothelium. The immunohistochemical (IHC) markers were as follows: calretinin (+), CK (+), desmin (-), HMB45 (-), Ki-67 (10%+), CD34 (-), MC (HBME-1) (+), melan-A (-), and B-catenin (+) ( Figure 2 ).

www.frontiersin.org

Figure 1 . ( A ) Numerous small nodules carpeting all visualized peritoneal and some parts of intestinal tube surfaces. ( B ) Tumor infiltrating the entire omentum and forming a large, firm mass.

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Figure 2 . Histology and immunohistochemistry of the omentum. ( A , B ) Mass of cells lined with a papillary structure of monolayer flat/cuboidal mesothelial cells with a milder nucleus and acidophilic cytoplasm (H&E, ×100). ( C , D ) Immunohistochemistry results for calretinin and MC (HBME-1) (×100).

Unfortunately, the patient refused to undergo therapy and chose to be discharged for recuperation. During the follow-up, he died at home 1 month after discharge.

Discussion and conclusions

Malignant peritoneal mesothelioma is an aggressive neoplasm of the serosal membranes, first reported by Miller and Wynn in 1908 ( 1 ). It accounts for approximately 25% of malignant mesotheliomas. Asbestos exposure is a well-recognized high-risk pathogenic factor for MPM ( 2 ). The patient was a deaf–mute construction worker with no clear history of asbestos exposure. Patients with peritoneal mesothelioma usually present with abdominal pain, distention, ascites, and an abdominal mass. Hydronephrosis rarely occurs as the first symptom. We searched PubMed for articles addressing peritoneal mesothelioma and hydronephrosis and found five relevant articles, screened by title and abstract. Two articles were finally included in the review. Detailed case data of four patients were obtained ( Table 1 ).

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Table 1 . Characteristics of four cases of peritoneal mesothelioma presenting with hydronephrosis, as screened from PubMed and our patient.

Among these cases, the majority had a survival period of only a few months after the first diagnosis. Four out of five presented with combined bilateral hydronephrosis. Ureteral stenting was initially used in the majority of patients to drain hydronephrosis. Renal function improvement was observed in two patients. Therefore, the drainage mode should be considered when dealing with ureteral obstruction. There is no consensus on the optimal method for malignant ureteral obstruction (MUO). Some studies ( 5 ) showed that the postoperative stent failure rate of extrinsic malignant ureteral obstruction was 42%–45%. However, there was no difference in median survival compared with PCN. Metallic stents and some new material stents provide more options. The type and level of obstruction, renal insufficiency, degree of hydroneurosis, and length of obstruction >3 cm have been identified as predictors of stent failure in MUO patients. Accordingly, all these aspects should be taken into consideration. Clinician preference and patient comfort are also important factors.

Diagnosing MPM is extremely challenging, as it is characterized by irregular or nodular peritoneal or mesenteric thickening, omental mass, and ascites in imaging evaluations. The accuracy of ascitic cytology is only 50% ( 6 ). Laparoscopy is superior to CT in the evaluation of localized peritoneal metastases. The gold standard for MPM diagnosis is pathological examination. Morphologically, there are mainly three subtypes of MPM: epithelioid, sarcomatoid, and biphasic. Epithelioid MPM is the most common and least aggressive subtype, accounting for approximately 60% of cases. Our patient belongs to the epithelioid type, as evidenced by the histological findings showing papillary hyperplasia of the overlying mesothelium. However, the diffused growth pattern of the tumor and the limited tissue obtained by laparoscopic biopsy present challenges for pathological examination. In combination with the prognosis of the patient, it can be mixed with a few sarcomatoid types. IHC staining is the most valuable and feasible method for the differential diagnosis of MPM ( 7 ). The recognized positive markers are calretinin, CK 5/6, WT-1, HBME-1, thrombomodulin, podoplanin, mesothelin, and D2-40, while the negative markers are TTF1, carcinoembryonic antigen (CEA), Ber Ep4, B72.3, MOC31, and CD15. It is recommended to use at least two positive and two negative markers for differential diagnosis ( 8 ).

In 2011, Yan et al. ( 9 ) proposed a TNM staging system based on the extent of peritoneal disease burden (T), intra-abdominal nodal metastasis (N), and extra-abdominal metastasis (M) to standardize and guide the clinical treatment and prognostic evaluation of MPM. The T stage is determined by calculating the peritoneal carcinomatosis index (PCI). This assessment combines lesion size (0–3) with tumor distribution (abdominopelvic and mesenteric regions 0–13) to quantify the extent of disease as a numerical score (PCI-0 to 39). The 5-year survival rates of stage I, II, and III patients were reported to be 87%, 53%, and 29%, respectively. The patient’s PCI was >30, categorizing MPM as stage III (T4). This staging was an independent prognostic factor for malignant peritoneal mesothelioma.

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the initial preferred treatment for MPM. An analysis by the US HIPEC Collaborative, including 130 patients with MPM (all histologic subtypes included) who underwent CRS-HIPEC, reported a 5-year OS of 67.8% and a conditional OS of 89.7%. The strongest predictor of long-term survival is complete cytoreduction ( 10 ). Our patient presented with diffuse MPM, with extensive peritoneal, small bowel serosal, or mesentery involvement, which is not amenable to complete cytoreduction. The proposed treatment plan is intravenous chemotherapy and HIPEC, and immunosuppressive therapy can be added if physical conditions allow. The current preferred intraperitoneal chemotherapy is cisplatin alone or in combination with cisplatin/doxorubicin, the most commonly used combination therapy. Systemic therapy is an alternative treatment for inoperable patients. The International Expanded Access Program assessed pemetrexed regimens for 109 patients with MPM. Patients received pemetrexed, pemetrexed plus cisplatin, or pemetrexed plus carboplatin as either first-line or second-line therapy. For patients who received pemetrexed plus cisplatin, the 1-year survival rate was 57.4%. For patients who received pemetrexed alone, the median survival rate was 10.3 months, and the 1-year survival rate was 41.5%. Survival rates are not available for pemetrexed plus carboplatin ( 11 ). In recent years, molecular therapy and immunotherapy have attracted increasing attention. BAP1, TP53, NF2, and ALK, which are commonly mutated genes in MPM ( 12 ), are expected to become potential therapeutic targets. A phase II study evaluated the activity of pembrolizumab in 64 mesothelioma patients who had been treated with one or two chemotherapy regimens. Among these patients, only eight (12.5%) had MPM, and they exhibited lower overall response rates than patients with pleural mesothelioma in the study. Whether PDL1 expression is predictive of benefit remains unknown. In another cohort study evaluating the clinical efficacy of immunotherapy in patients with advanced MPM, the overall response rate was 19%, with a reported median progression-free survival (PFS) of 5.5 months ( 13 ) . Immunotherapy is an exciting future direction for MPM, and we look forward to the results of more clinical trials.

Peritoneal mesothelioma with bilateral hydronephrosis as the first symptom is rare and the diagnosis can be confirmed by laparoscopic exploration biopsy when necessary. Because of severe ureteral compression, PCN, or metal stents with high tension, offer more advantages than ordinary stents in improving renal function.

Data availability statement

The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author.

Ethics statement

This study involving humans was approved by the ethics committee of the Guiqian International General Hospital. The studies were conducted in accordance with local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Written informed consent was obtained from the participant/patient(s) for the publication of this case report.

Author contributions

JL: Conceptualization, Data curation, Validation, Writing – original draft, Writing – review & editing. JP: Resources, Writing – review & editing. CZ: Investigation, Software, Validation, Writing – review & editing. LW: Formal analysis, Validation, Writing – review & editing. HZ: Conceptualization, Funding acquisition, Methodology, Project administration, Writing – review & editing.

The authors declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fsurg.2024.1342657/full#supplementary-material

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5. Chung SY, Stein RJ, Landsittel D, Davies BJ, Cuellar DC, Hrebinko RL, et al. 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents. J Urol . (2004) 172(2):592–5. doi: 10.1097/01.ju.0000130510.28768.f5

6. Manzini VP, Recchia L, Cafferata M, Porta C, Siena S, Giannetta L, et al. Malignant peritoneal mesothelioma: a multicenter study on 81 cases. Ann Oncol . (2010) 21(2):348–53. doi: 10.1093/annonc/mdp307

7. Marchevsky AM. Application of immunohistochemistry to the diagnosis of malignant mesothelioma. Arch Pathol Lab Med . (2008) 132(3):397–401. doi: 10.5858/2008-132-397-AOITTD

8. Suster S, Moran CA. Applications and limitations of immunohistochemistry in the diagnosis of malignant mesothelioma. Adv Anat Pathol . (2006) 13(6):316–29. doi: 10.1097/01.pap.0000213064.05005.64

9. Yan TD, Deraco M, Elias D, Glehen O, Levine EA, Moran BJ, et al. A novel tumor-node-metastasis (TNM) staging system of diffuse malignant peritoneal mesothelioma using outcome analysis of a multi-institutional database. Cancer . (2011) 117(9):1855–63. doi: 10.1002/cncr.25640

10. Steadman JA, Grotz TE. Principles of surgical management of peritoneal mesothelioma. J Natl Compr Canc Netw . (2023) 21(9):981–6. doi: 10.6004/jnccn.2023.7055

11. Ettinger DS, Wood DE, Stevenson J, Aisner DL, Akerley L, Bauman JR, et al. Mesothelioma: peritoneal, version 2.2023, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw . (2023) 21(9):961–79. doi: 10.6004/jnccn.2023.0045

12. Kim JE, Kim D, Hong YS, Kim KP, Yoon YK, Lee DH, et al. Mutational profiling of malignant mesothelioma revealed potential therapeutic targets in EGFR and NRAS. Transl Oncol . (2018) 11(2):268–74. doi: 10.1016/j.tranon.2018.01.005

13. Menezes MB, Lima R, Dunões I, Inácio M, Dinis R. A complete response to pembrolizumab in malignant peritoneal mesothelioma: a case report. Cureus . (2024) 16(1):e52716. doi: 10.7759/cureus.52716

Keywords: peritoneal mesothelioma, hydronephrosis, percutaneous nephrostomy, ureteral stent, case report

Citation: Luo J, Pan J, Zhong C, Wang L and Zhang H (2024) Malignant peritoneal mesothelioma presenting with bilateral hydronephrosis and renal insufficiency: a case report and literature review. Front. Surg. 11:1342657. doi: 10.3389/fsurg.2024.1342657

Received: 22 November 2023; Accepted: 3 April 2024; Published: 24 April 2024.

Reviewed by:

© 2024 Luo, Pan, Zhong, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Heng Zhang [email protected]

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    Here are 4 tips that should help you perfect your pronunciation of 'presentation':. Break 'presentation' down into sounds: [PREZ] + [UHN] + [TAY] + [SHUHN] - say it out loud and exaggerate the sounds until you can consistently produce them.; Record yourself saying 'presentation' in full sentences, then watch yourself and listen.You'll be able to mark your mistakes quite easily.

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    naturalness matters more. In an academic presentation, clarity matters more- it's all about the situation. 1 To make a neutral vowel, just let your tongue sit in the middle of your mouth (not top or bottom or front or back) and let the noise come out. The "er" at the end of "carpenter" or "computer" is a good example.

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    Australian English Pronunciation Pronunciation can only be improved by using it - so the most important advice is to talk, talk and talk. ... In an academic presentation, clarity matters more - it's all about the situation. Another useful trick is intonation - your voice going up (like Mariah Carey) or down (like Louis ...

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    Intensive Pronunciation Program Overview Objectives: • to develop an awareness of the important features of pronunciation • to identify common problems for both individual and groups of students • to practise listening for pronunciation features and incorporating them into dialogues, role plays and presentations

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    The following page intends to give some useful tips and advice on improving pronunciation whilst giving a presentation. Get physical Do some 'warm-ups' to loosen up your mouth and your tongue before you speak. ... PRV12060 - TEQSA Category: Australian University - ABN: 77 257 686 961 - 19 September 2017 01:30 PM. The page is authorised by the ...

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  8. Lesson 8: The Aussie /ɐ/ Sound

    When the Australian /ɐ/ sound is followed by a consonant sound, two things happen. The Australian R /ɹ/ sound remains silent, and. The Australian /ɐ/ sound will turn into the standard weakened syllable /ə/ vowel sound. The most common situations is when a /z/ sound is added on to the ends of /ɐ/ word endings.

  9. How to pronounce Australia in English

    How to pronounce Australia. How to say Australia. Listen to the audio pronunciation in the Cambridge English Dictionary. Learn more.

  10. Presentation

    Presentation - pronunciation: audio and phonetic transcription presentation American English: [ˌpɹɛzn̩ˈteɪʃən] IPA /prEzntAYshUHn/ phonetic spelling Mike x0.5 x0.75 x1 Lela x0.5 x0.75 x1 Jeevin x0.5 x1 Jeevin x0.5 x1 British English: [ˌprezənˈteɪʃən] IPA /prEzUHntAYshUHn/ phonetic spelling Andrew x0.5 x0.75 x1

  11. How to pronounce presentation

    Meanings for presentation. the act of making something publicly available; presenting news or other information by broadcasting or printing it. the act of presenting a proposal. the activity of formally presenting something (as a prize or reward) presentation of his book. presentation of new products.

  12. Australian English: Examples, Accent, Pronunciation, Words

    For example, R at the end of a word is not pronounced. Car sounds like 'cah'. Jar sounds like 'jah'. G at the end of a word is not pronounced. Dancing is dancin and going is goin in Australian pronunciation. I in words like sit is pronounced as 'ee' making it sound 'seet' instead of sit. 'th' sound is replaced by 'f' or ...

  13. Australian accent generator

    Narakeet makes it easy to create videos and audio files with life-like audio from text. Get started with Australian English text to speech free. Select from one of our text-to-speech Australian English male and female voices below, and enter some text to create the audio. In addition to these voices, Narakeet has 700 text-to-speech voices in 90 ...

  14. Australian English phonology

    Australian English (AuE) is a non-rhotic variety of English spoken by most native-born Australians. Phonologically, it is one of the most regionally homogeneous language varieties in the world. Australian English is notable for vowel length contrasts which are absent from most English dialects.. The Australian English vowels /ɪ/, /e/, /eː/ and /oː/ are noticeably closer (pronounced with a ...

  15. MP3 How to Pronounce Australia

    How to Pronounce Australia - (Audio) | Britannica Dictionary. " Australia ". Listen to the audio pronunciation again. /ɑˈstreɪljə/. Having trouble hearing a pronunciation? * Click here to listen with your default audio player . Meta description: Hear the pronunciation of Australia in American English, spoken by real native speakers.

  16. Consonants: Pronunciation Tutorials

    Australian English Pronunciation. 0% Complete 0/0 Steps Start Here. Section 1: Learn the International Phonetic Alphabet. An Introduction to the IPA. 13 Topics Section 2: The Sounds of Australian English. Consonants: Pronunciation Tutorials. 26 Topics . b - e.g. bar, cub ...

  17. Learn Aussie English with Amanda

    An Image/Link below is provided (as is) to download presentation Download Policy: ... 6 WEEK SPEAKING CLUB • AUSTRALIAN ENGLISH PRONUNCIATION ESSENTIALS - 6 WEEK INTENSIVE GROUP COURSE. ONLINE COURSES (COMING SOON) Thank You +61411859398 @aussie.english.with.amanda [email protected] www.aussieenglishwithamanda.com ...

  18. Pronunciations for Australia (from Commonwealth of Australia to Moe

    Search for Australia audio pronunciation in Forvo, the largest pronunciation guide in the world. Learn to pronounce Australia as a native (from Commonwealth of Australia to Moe, Victoria, Australia)

  19. History of Australian English

    1916. 1855. 1788. What is it that makes Australians sound Australian? + info. Aboriginal and Torres Strait Islander people spoke 800 dialects in Australia by the time of European colonization. Australian is a new dialect of English and is a non-rhotic variation.

  20. Australian English text to speech generator (en-AU)

    Australian English pronunciation is characterized by a distinctive accent, which is marked by a general flattening of vowel sounds, such as in words like "dance" and "grass." Additionally, there are several unique Australian words and phrases that are not commonly used in other English-speaking countries. For example, "arvo" is a slang term ...

  21. How Word Pronunciation has Changed Over Time PowerPoint

    The suggested learning intention and success criteria of this resource are outlined below. LI: We are learning that the pronunciation, spelling and meanings of words have histories and have changed over time. SC: I can identify and explain some ways in which words have changed and evolved over time. Twinkl Australia 5 - 6 Australian Curriculum ...

  22. Digital Transformation Tech Talk presentation slides

    This publication contains the presentation slides of the second Digital Transformation Tech Talk webinar of 2024. During this webinar, we looked at latest updates on digital transformation for the aged care sector. ... The Department of Health and Aged Care acknowledges the traditional owners of country throughout Australia, and their ...

  23. Australian English

    Australian English pronunciation. How to say Australian English. Listen to the audio pronunciation in English. Learn more.

  24. Australia

    Australia pronunciation. How to say Australia. Listen to the audio pronunciation in English. Learn more.

  25. Bestiality references allegedly made during presentation at Renmark

    An investigation is underway into a presentation delivered to year 9 girls at Renmark High School.(ABC Riverland: Sophie Landau) In short: Year 9 girls at Renmark High School say they were given a ...

  26. Malignant peritoneal mesothelioma presenting with bilateral

    1 Department of Urology, Guiqian International General Hospital, Guiyang, China; 2 Department of Pathology, Guiqian International General Hospital, Guiyang, China; Introduction: Malignant peritoneal mesothelioma (MPM) is an extremely rare tumor with nonspecific clinical manifestations, making diagnosis challenging. Case presentation: Herein, we report a case of MPM with occult onset presenting ...