A case of solid pseudopapillary tumour of the pancreas and malignant mesothelioma

Our plain-English summary of A case of solid pseudopapillary tumour of the pancreas and malignant mesothelioma, by J.C. Hu, W. Brookings, M.C. Aldridge (Journal of Gastrointestinal Cancer, 2007).

The study

• Authors: J.C. Hu, W. Brookings, M.C. Aldridge
• Journal: Journal of Gastrointestinal Cancer
• Published: 2007;38(2-4):71-3
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Introduction: A 59-year-old man with previous exposure to asbestos presented with dyspnoea and pleuritic chest pain, had a pleural effusion and was treated for pneumonia. His symptom recurred and was found to have an abdominal mass.

Discussion: An abdominal computerised tomogram revealed pancreatic body mass arising. Pleural fluid cytology and a pleural biopsy failed to demonstrate malignancy. The pancreatic tumour was resected by distal pancreatectomy, segmental colectomy and splenectomy. The tumour was a solid pseudopapillary pancreatic tumour (SPT) with a high metastatic potential. The patient deteriorated and a repeat biopsy of the thickened pleura confirmed malignancy which was initially thought to be metastases from the SPT. Immunohistochemical staining confirmed malignant mesothelioma. The patient developed liver metastases and died 2 years from the diagnosis of metastatic disease.

In plain English

This case report described one patient, a 59-year-old carpenter with previous asbestos exposure, who had two rare tumours at once. He first had breathlessness, a dry cough and chest pain with fluid around the lung, and he improved with treatment for presumed pneumonia. When his symptoms returned, a scan found a 13-cm tumour in the pancreas. A pleural fluid sample and a pleural biopsy did not show cancer. Surgeons removed the tumour with the spleen and part of the colon. It was a solid pseudopapillary tumour of the pancreas with features suggesting malignant potential. A further pleural biopsy found cancer cells, first thought to have spread from the pancreas, but staining confirmed malignant mesothelioma of the epithelial type. Liver tumours that appeared 10 months after surgery came from the pancreatic tumour. He died 2 years after presentation. The authors said the mesothelioma diagnosis was delayed and concluded that diagnosing rare tumours can be complicated. They suggested, without testing it, that the pancreatic tumour may be associated with factors that predispose people to mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: One 59-year-old male carpenter with previous asbestos exposure, treated at the Department of Surgery, Queen Elizabeth II Hospital, Welwyn Garden City, UK. Dates of care are not given.
• Exposure: Previous asbestos exposure in a carpenter. The fiber type, source, duration and amount are not described.
• Main results:
  • A CT scan showed a 13-cm tumour in the body of the pancreas.
  • Initial pleural fluid and biopsy testing did not find pleural cancer.
  • The pancreatic tumour was removed by distal pancreatectomy, splenectomy and partial colectomy because it was stuck to the transverse colon.
  • The pancreatic tumour (solid pseudopapillary tumour) showed features suggesting malignant potential.
  • A further pleural biopsy was at first thought to show spread from the pancreatic tumour, but staining confirmed malignant mesothelioma of the epithelial cell type.
  • Multiple liver metastases developed 10 months after the operation. Biopsy showed they came from the pancreatic tumour.
  • The patient died 2 years after presentation from metastatic disease.
  • The authors stated that the diagnosis of mesothelioma in this patient was delayed.
  • The authors suggested, as a possibility, that the pancreatic tumour may be associated with factors that predispose patients to mesothelioma.
• The authors' conclusion: The authors concluded that this case showed that diagnosing rare tumours can be complicated and that all aspects should be considered. They stated that pathology, especially immunohistochemistry, resolved the diagnostic uncertainty in this patient.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleuritic Chest Pain, Pleural Effusion, Fluid Cytology, Pleural Biopsy, Biopsy, Pleura, Immunohistochemistry.

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