Bubbles in the belly - Cystic mesothelioma

Our plain-English summary of Bubbles in the belly - Cystic mesothelioma, by A. Chandramohan, R. Mittal (The Indian Journal of Medical Research, 2020).

The study

• Authors: A. Chandramohan, R. Mittal
• Journal: The Indian Journal of Medical Research
• Published: 2020;152(Suppl 1):S229-S230
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This two-page article was a brief clinical image report about one patient. It contained no discussion section and drew no general conclusions. A 25-year-old woman came to the departments of Medicine and then Surgery at Christian Medical College, Vellore, India, in December 2018. She had had abdominal pain and swelling for six months. Tests showed a large amount of fluid in the abdomen (ascites), and tests for tuberculosis, Budd-Chiari syndrome and malignant ascites were negative. The fluid persisted despite nine months of anti-tuberculosis treatment given without a confirmed diagnosis. Computed tomography showed fluid divided into pockets, scalloping of the liver surface and mild thickening of the omentum. Magnetic resonance imaging in October 2019 showed many thin-walled cysts filling the peritoneal cavity. Laparoscopy also showed these cysts. A biopsy with calretinin and D2-40 staining confirmed cystic mesothelioma. At three months of follow-up the fluid persisted. She was advised to have cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), which she had not yet had. The article did not mention asbestos or any other exposure.

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 (clinical image report of a single patient)
• Who was studied: One 25-year-old woman seen at Christian Medical College, Vellore, India, starting in December 2018
• Exposure: Not reported. The article does not mention asbestos or any other exposure.
• Main results:
  • The patient had abdominal pain and distension for six months before presenting.
  • Tests showed high serum ascites albumin gradient (SAAG), low protein massive ascites, and negative tests for tuberculosis, Budd-Chiari syndrome and malignant ascites.
  • Ascites persisted despite empirical anti-tuberculosis therapy for nine months.
  • Computed tomography showed loculated ascites scalloping the liver and mild omental thickening.
  • MRI in October 2019 showed multiloculated cystic lesions filling the peritoneal cavity. This was confirmed by laparoscopy and was suggestive of cystic mesothelioma.
  • Histopathology of a biopsy with calretinin and D2-40 immunohistochemical staining confirmed cystic mesothelioma.
  • At three months of follow-up the patient still had ascites. She was advised cytoreductive surgery and HIPEC, which she had not yet had.
• The authors' conclusion: The authors did not state a conclusion. The article describes one case only.

Topics

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

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• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)
• Benign cystic mesothelioma of the peritoneum in a child-case report and review of the literature — V.C. Shakya, C.S. Agrawal, et al. (2011)
• Pediatric Benign Cystic Peritoneal Mesothelioma — J. Durell, H. Dagash, et al. (2016)
• Benign cystic mesothelioma: a diagnostic dilemma — T.S. Usha Kiran, A. Agboola, et al. (2002)
• Cystic appearance of a malignant peritoneal mesothelioma by ultrasonography and computed tomography: a case report — K.W. Preidler, H. Steiner, et al. (1994)
• Benign cystic mesothelioma: false-positive iodine accumulation in a patient with oncocytic follicular thyroid carcinoma — M. Meyer, Y. Godbert, et al. (2014)

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