A Rare Case of Malignant Pleural Mesothelioma with Metastases to the Pancreas Concurrently Diagnosed with Invasive Ductal Adenocarcinoma

Our plain-English summary of A Rare Case of Malignant Pleural Mesothelioma with Metastases to the Pancreas Concurrently Diagnosed with Invasive Ductal Adenocarcinoma, by C. Wuthnow, Y.H. Agha, S. Srinivasan, et al (Kansas Journal of Medicine, 2020).

The study

• Authors: C. Wuthnow, Y.H. Agha, S. Srinivasan, W. Salyers, N. Tofteland
• Journal: Kansas Journal of Medicine
• Published: 2020;13:269-271
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This case report described one patient, a 61-year-old woman with no past medical history. She was hospitalized for abdominal pain that a CT scan showed was consistent with acute diverticulitis. The scans also found a left lung mass and a right breast mass. A lung biopsy showed pleural mesothelioma, epithelioid type, and a breast biopsy showed infiltrative ductal adenocarcinoma. The article states that she had no history of exposure to asbestos. She had a radical right mastectomy and chemotherapy: pemetrexed for the mesothelioma, and carboplatin, pertuzumab and trastuzumab for the breast cancer. Follow-up scans showed the lung mass had shrunk. Two years after diagnosis, a 1.8 x 1.6 cm mass was found in the pancreas, and a needle sample was consistent with mesothelioma that had spread there. The article says in one place that she was doing well 55 months after diagnosis, and in another that she was alive 5.5 years after diagnosis. The authors concluded that, to their knowledge, she was the second reported case of pleural mesothelioma spreading to the pancreas. They also concluded she was the first diagnosed with both this mesothelioma and infiltrative ductal adenocarcinoma.

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 (single patient)
• Who was studied: one 61-year-old woman with no past medical history, hospitalized for acute abdominal pain; place and date of care not stated
• Exposure: The article reports that the patient had no history of asbestos exposure; no fiber type or job is described
• Main results:
  • A CT-guided lung biopsy showed pleural mesothelioma, epithelioid type
  • A breast biopsy showed infiltrative ductal adenocarcinoma (ER/PR negative, HER2/Neu positive)
  • Treatment was a radical right mastectomy with right axillary lymph node resection, pemetrexed for the mesothelioma, and carboplatin, pertuzumab and trastuzumab for the breast cancer
  • Follow-up PET/CT scans showed a significant reduction in size and metabolic activity of the left lung mass
  • Two years after diagnosis and treatment, a 1.8 x 1.6 cm mass was found in the distal body and tail of the pancreas
  • Fine needle aspiration of the pancreatic mass gave pathology consistent with metastatic malignant pleural mesothelioma. The figure captions report positive staining for calretinin, WT1 and cytokeratin 7
  • The patient was reported as doing well 55 months after diagnosis (introduction) and as still alive 5.5 years after diagnosis (discussion)
• The authors' conclusion: The authors concluded that, to their knowledge, this was the second reported case of malignant pleural mesothelioma with metastases to the pancreas. They also concluded it was the first patient diagnosed with multiple primary malignancies that included malignant pleural mesothelioma and infiltrative ductal adenocarcinoma. They suggested that genetic alterations seen in both cancers could have contributed to both developing at the same time.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Adenocarcinoma.

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