An unusual case of mesothelioma

Our plain-English summary of An unusual case of mesothelioma, by D. Gothi, A. Verma, R.B. Sah (Lung India, 2015).

The study

• Authors: D. Gothi, A. Verma, R.B. Sah
• Journal: Lung India
• Published: 2015;32(2):194-5
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This letter to the editor was a case report about one patient. A 26-year-old non-smoking woman, a homemaker from Bisai in Bihar state, India, had right-sided chest pain and worsening breathlessness for four months. An interview with her father did not reveal asbestos exposure at home or at work. Scans showed a right chest mass that had grown through the diaphragm to the liver surface, with a few liver metastases, and separate deposits along the pelvic lining (peritoneum). Staining tests on a lung biopsy confirmed epithelioid malignant mesothelioma; a needle sample of the pelvic mass was consistent with either adenocarcinoma or epithelioid mesothelioma. The authors described the case as pleural plus peritoneal mesothelioma at stage IV. Radiotherapy reduced the symptoms of a blocked major vein (superior vena cava syndrome). She stopped chemotherapy after one cycle. The authors suggested the disease was possibly caused by environmental exposure from coal mines in Jharia-Dhanbad, where she had lived for six months at age five. They called for finding more patients from that area and looking for the environmental cause.

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 (letter to the editor)
• Who was studied: One 26-year-old non-smoking woman, a homemaker, who lived in Bisai, Bihar state, India, except for six months in Jharia-Dhanbad at five years of age
• Exposure: No asbestos exposure was found at home or at work. The authors suspected environmental exposure from coal mines in Jharia during six months of residence at age five. No fiber type was identified.
• Main results:
  • Immunohistochemistry of the lung biopsy confirmed epithelioid malignant mesothelioma: calretinin and WT1 positive; CEA, CD15, EMA and TTF1 negative
  • Needle aspiration of the axillary lymph node and the pelvic mass, and the ultrasound-guided lung biopsy, showed a malignant epithelial tumor consistent with either adenocarcinoma or epithelioid mesothelioma; immunohistochemistry was reported for the lung biopsy only
  • The right chest mass had crossed the diaphragm, with scalloping of the liver surface and a few liver metastases
  • The authors described the patient as having both a pleural mass and a pelvic peritoneal mass due to mesothelioma
  • The disease was classed as stage IV
  • Tests for EGFR and ALK on the lung biopsy were negative
  • Radiotherapy reduced symptoms of superior vena cava syndrome
  • The patient received one cycle of cisplatin and pemetrexed chemotherapy and then stopped treatment
• The authors' conclusion: The authors concluded that the case had many unusual findings: mesothelioma possibly due to coal-mine exposure, a very young age at presentation, superior vena cava syndrome, and combined pleural and peritoneal mesothelioma. They said it is essential to identify more patients from the locality and look for the environmental cause.

Topics

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

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