Case report: Rare intrapulmonary malignant mesothelioma complicated with myositis

Our plain-English summary of Case report: Rare intrapulmonary malignant mesothelioma complicated with myositis, by D. Gong, J. Yu, X. Jiang (Frontiers in Oncology, 2022).

The study

• Authors: D. Gong, J. Yu, X. Jiang
• Journal: Frontiers in Oncology
• Published: 2022;12:1074821
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant pleural mesothelioma is an uncommon aggressive tumor. Its incidence is even lower when the lung parenchyma is the primary site. Myositis is a common paraneoplastic syndrome, but it rarely presents with malignant pleural mesothelioma. This report presents a rare intrapulmonary malignant mesothelioma complicated by cancer-associated myositis. The patient presented with limb muscle weakness as the first symptom and was diagnosed with intrapulmonary malignant mesothelioma complicated by cancer-associated myositis on the basis of clinical, histological, immunohistochemical, and radiological findings. The patient responded poorly to conventional hormone therapy and died of respiratory failure within 2 months after the first presence of limb muscle weakness.

Copyright © 2022 Gong, Yu and Jiang.

In plain English

This article is a case report about one patient at the Second Hospital of Dalian Medical University in China in 2022. A 66-year-old man came to the hospital after one month of weakness in his arms and legs. He smoked 20 cigarettes a day and had a family history of lung cancer. The authors reported that he had no history of asbestos exposure. Scans found a 26 mm mass in the right upper lobe of the lung, with enlarged lymph nodes measuring 18 mm. No abnormal uptake was seen at other sites, including the pleura (the lining around the lungs). A needle biopsy and tissue staining were consistent with epithelioid malignant mesothelioma arising inside the lung. Blood tests found anti-NXP2 antibodies, which the authors took to indicate cancer-associated myositis, a cancer-linked muscle inflammation. Surgery and radiotherapy were judged unsuitable. He received the steroid methylprednisolone for 7 days, responded poorly, and died of respiratory failure 2 months after his weakness began. The authors concluded that cancer-associated myositis may occur with this tumor. They believed this was the first such reported case.

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 (a single patient)
• Who was studied: One 66-year-old man treated at the Second Hospital of Dalian Medical University, Dalian, China, in 2022. He had diabetes mellitus for 15 years.
• Exposure: The authors state the patient had no history of asbestos exposure. He was an active smoker (20 cigarettes/day) with a family history of lung cancer.
• Main results:
  • PET-CT showed a soft tissue lesion and enlarged lymph nodes in the right lobe, measuring 26 mm and 18 mm in diameter respectively. No abnormal uptake was seen elsewhere, including the lungs and pleura.
  • Biopsy tissue staining was positive for calretinin, WT-1 and CK5/6 and negative for TTF-1 and p40. The authors judged this consistent with epithelioid malignant mesothelioma.
  • Other autoantibodies were negative, but anti-NXP2 antibody was positive. The authors took this to indicate cancer-associated myositis.
  • Because of the patient's poor performance status, surgery and radiotherapy were judged unsuitable. Antibiotics and intensive care were given.
  • The patient received methylprednisolone 80 mg/day for 7 days. He responded poorly, with worsening limb weakness, and died of respiratory failure.
  • The time from onset of limb weakness to death was 2 months.
• The authors' conclusion: The authors concluded that cancer-associated myositis may be present in patients with intrapulmonary malignant mesothelioma. To their knowledge, this was the first reported case of the combination. They described the disease as fast-progressing with poor prognosis and a poor response to methylprednisolone.

Topics

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

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