Concurrent alcoholic cirrhosis and malignant peritoneal mesothelioma in a patient: A case report

Our plain-English summary of Concurrent alcoholic cirrhosis and malignant peritoneal mesothelioma in a patient: A case report, by L. Liu, X.Y. Zhu, W.J. Zong, et al (World Journal of Clinical Cases, 2022).

The study

• Authors: L. Liu, X.Y. Zhu, W.J. Zong, C.L. Chu, J.Y. Zhu, X.J. Shen
• Journal: World Journal of Clinical Cases
• Published: 2022;10(19):6716-6721
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant peritoneal mesothelioma (MPM) originates from the mesothelial and subcutaneous cells of the abdominal cavity. Its diagnose is difficult due to its nonspecific and vague symptoms, and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers. Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases. To the best of our knowledge, no case of MPM concurrent with alcoholic cirrhosis has been reported.

Case Summary: A 63-year-old man presented to our hospital with abdominal distension for 20days. He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure. After treatment for alcoholic cirrhosis in a community hospital, his symptoms did not improve significantly. The patient underwent exploratory laparotomy and surgical resection. Pathologic examination showed an epithelioid MPM. He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery. Currently, he is in a stable condition and tumor recurrence has not occurred.

Conclusion: Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset. Therefore, there is a need to understand. MPM in clinical practice, make the correct diagnosis, and provide timely and effective treatment.

©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

In plain English

This article was a case report from a hospital gastroenterology department in Jinan, Shandong Province, China. It described one 63-year-old man who came to the hospital after 20 days of abdominal swelling (distension). He had drunk alcohol for nearly 30 years and had no history of special drug use or toxic exposure. The article did not say whether he had ever been exposed to asbestos. A community hospital had diagnosed alcoholic cirrhosis, liver cysts and fluid in the abdomen (ascites), but his symptoms did not improve much with cirrhosis treatment. At the authors' hospital, cancer cells were found in the abdominal fluid, and a contrast CT scan showed irregular thickening of the right peritoneum. At surgery, many round masses 3-20 mm across were found on the abdominal lining. Tissue examination showed epithelioid malignant peritoneal mesothelioma. He received pemetrexed with cisplatin and intraperitoneal hyperthermic perfusion. After 11 months of follow-up he was stable with no recurrence. The authors concluded that this cancer is easily misdiagnosed or missed because it begins insidiously. They noted that the link between alcoholic cirrhosis and the cancer remains unknown.

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 63-year-old man treated at the Department of Gastroenterology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China. Dates of care are not given.
• Exposure: The patient had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure. The article does not report on asbestos exposure for this patient.
• Main results:
  • A community hospital had diagnosed multiple hepatic cysts, alcoholic cirrhosis and ascites on CT. After treatment for alcoholic cirrhosis, the patient's symptoms did not improve significantly.
  • Malignant tumor cells were found in the cells shed into the patient's ascites fluid.
  • A contrast-enhanced CT scan showed a large amount of abdominal fluid, an irregularly thickened right peritoneum, and nodular thickening of the greater omentum.
  • At exploratory laparotomy, multiple round masses 3-20 mm in diameter were seen on the parietal and visceral peritoneum. The right subphrenic peritoneum was considerably thickened over an area of about 15 cm by 15 cm.
  • Pathologic examination of the resected tissue showed an epithelioid malignant peritoneal mesothelioma.
  • After surgery, the patient received pemetrexed in combination with cisplatin, plus intraperitoneal hyperthermic perfusion.
  • At 11 months of follow-up, the patient was in stable condition with no tumor recurrence.
• The authors' conclusion: The authors concluded that malignant peritoneal mesothelioma is prone to misdiagnosis and missed diagnosis because of its insidious onset. They said clinicians should be aware of the disease so they can diagnose and treat it in time.
• Limitations the authors state:
  • The relationship between alcoholic cirrhosis and malignant peritoneal mesothelioma remains unknown, and further studies are needed.
  • Long-term follow-up is still needed.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Misdiagnosis, Laparotomy, Surgical Resection, Epithelioid, Chemotherapy.

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