Brain Metastases With Malignant Peritoneal Mesothelioma: Never Reported Before

Our plain-English summary of Brain Metastases With Malignant Peritoneal Mesothelioma: Never Reported Before, by D. Lal, M. Misiura, W. Adeel, et al (Curēus, 2023).

The study

• Authors: D. Lal, M. Misiura, W. Adeel, R. Tariq
• Journal: Curēus
• Published: 2023;15(8):e43744
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma is a very rare diagnosis. Malignant mesotheliomas arise from surface linings of pleura, peritoneal cavity, or tunica vaginalis and pericardium with pleural malignant mesotheliomas being the most common. The incidence of brain metastases has been very low with malignant pleural mesotheliomas, but to date, there have not been any cases reported of brain metastasis with malignant peritoneal mesotheliomas. We present a patient diagnosed with malignant peritoneal mesothelioma and was successfully treated with immunotherapy for over two years but later presented with brain metastases. Although the patient had a surgical resection followed by brain radiation, he died three months after his diagnosis of brain metastases. Immunotherapy has revolutionized the treatment of malignant mesothelioma, and patients are living longer than before. We present this patient to increase awareness of brain metastases with malignant peritoneal mesothelioma. This case also highlights that we need to investigate different treatment options for brain metastases in patients with malignant mesothelioma as conventional treatment options like surgical resection and brain radiation are not very effective.

Copyright © 2023, Lal et al.

In plain English

This article was a case report describing one patient: a 59-year-old man with malignant peritoneal mesothelioma (mesothelioma of the abdominal lining) that later spread to the brain. The article did not mention asbestos or any other exposure. The patient had abdominal pain and weight loss in May 2020 and an 11.5 x 8 cm liver mass. Pathology after surgery confirmed peritoneal mesothelioma. Chemotherapy with cisplatin and pemetrexed was followed by local progression. From September 2020 he received the immunotherapy drugs ipilimumab and nivolumab, with what the authors described as an excellent response. Worsening peritoneal disease in June 2022 was removed surgically. In January 2023 a mass in the left cerebellum was found and confirmed on pathology as mesothelioma. After surgery and brain radiation, new brain tumors appeared, and he died three months after the brain diagnosis. The authors reported that their literature search found no earlier report of brain spread from peritoneal mesothelioma. They concluded that the case highlights recognizing brain metastases early and looking for treatments other than surgery and brain radiation.

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 59-year-old man who presented in May 2020 with abdominal pain and weight loss and a liver mass, later diagnosed with malignant peritoneal mesothelioma; the article does not state where he was treated beyond the authors' affiliation (Lehigh Valley Health Network, Allentown, USA)
• Exposure: Not reported; the article does not mention asbestos or any other exposure
• Main results:
  • The patient had an 11.5 x 8 cm liver mass, initially biopsied as sarcomatoid carcinoma; after partial hepatectomy, pathology confirmed malignant peritoneal mesothelioma
  • After three cycles of cisplatin and pemetrexed chemotherapy, the cancer progressed locally
  • On ipilimumab plus nivolumab immunotherapy, started September 2020, the patient had an excellent response
  • In January 2023 the patient developed acute headaches; MRI showed a 3.2 x 2.9 x 2.9 cm mass in the left cerebellum, confirmed as malignant mesothelioma on pathology
  • Despite surgical resection and brain radiation, the patient developed multiple new brain metastases, moved to hospice, and died three months after the brain metastasis diagnosis
  • The patient lived almost three years with the mesothelioma diagnosis
  • The authors' literature search found no previously reported case of brain or central nervous system metastasis from peritoneal mesothelioma
• The authors' conclusion: The authors concluded that the case highlights the importance of recognizing brain metastases early in malignant peritoneal mesothelioma and of looking for treatment options other than conventional surgical resection and brain radiation

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelioma, Pleura, Peritoneal Cavity, Tunica Vaginalis, Pericardium, Pleural Mesothelioma, Metastasis.

Related studies

• Malignant mesothelioma with brain metastases — J.A. Kaye, A.M. Wang, et al. (1986)
• Brain metastases in malignant pleural mesothelioma. Case report and review of the literature — K.S. Sridhar, A.M. Hussein, et al. (1989)
• Brain metastases in malignant pleural mesothelioma — T. Yamagishi, N. Fujimoto, et al. (2016)
• Response to chemotherapy of brain metastases from malignant pleural mesothelioma — M. Colleoni, G. Liessi, et al. (1996)
• Meningeal and brain metastases in primary malignant pericardial mesothelioma — U. Bohn, J.L. Gonzalez, et al. (1994)
• Brain Metastases in Diffuse Pleural Mesothelioma: Clinical, Histologic, and Molecular Correlates — A. Ocejo, C. Wilhem, et al. (2026)

Browse more research in Curēus, or return to medical research.