Cutaneous metastasis from pleural mesothelioma at site of radiation therapy: Case report and review of the literature

Our plain-English summary of Cutaneous metastasis from pleural mesothelioma at site of radiation therapy: Case report and review of the literature, by W. Abou Shahla, D.M. Khoury, D. Saade (JAAD Case Reports, 2024).

The study

• Authors: W. Abou Shahla, D.M. Khoury, D. Saade
• Journal: JAAD Case Reports
• Published: 2024;54:37-40
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This article is a case report, with a short discussion of earlier published reports. It described a 68-year-old man who had been diagnosed a year earlier with right-sided malignant pleural mesothelioma and treated with chemotherapy and immunotherapy. After the disease progressed, he received palliative radiotherapy (30 Gy in 10 fractions) to the mediastinum. Skin lesions then began on the right side of his chest after the radiation. They spread over the whole irradiated area and some surrounding skin, forming hard, red papules and plaques over the upper chest and lower neck. A skin biopsy showed tumor cells, with invasion of lymphatic vessels, that stained positive for the mesothelial markers cytokeratin 5/6, calretinin and Wilms tumor 1. The lesions were diagnosed as metastasis from the pleural mesothelioma. He died shortly afterward. The article did not report whether he had been exposed to asbestos. The authors concluded that radiotherapy might lead to skin metastasis appearing preferentially on irradiated skin. They said clinicians should watch for skin involvement in mesothelioma patients, especially on irradiated areas.

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 of a single patient, with a brief narrative discussion of previously published reports
• Who was studied: One 68-year-old man with malignant pleural mesothelioma, seen by the Department of Dermatology, American University of Beirut Medical Center, Lebanon; dates not given
• Exposure: The article does not report any asbestos exposure for this patient. The exposure discussed is palliative radiotherapy (30 Gy in 10 fractions) to the mediastinum, given because of disease progression with superior vena cava syndrome.
• Main results:
  • The patient had been diagnosed a year before presentation with right-sided malignant pleural mesothelioma and had received chemotherapy and immunotherapy
  • The skin lesions began on the right side of the chest after radiation therapy to that area
  • The lesions spread to cover the entire irradiated surface and some surrounding areas
  • Biopsy showed lymphatic invasion, and the tumor cells were positive for the mesothelial markers cytokeratin 5/6, calretinin, and Wilms tumor 1
  • The skin lesions were diagnosed as cutaneous metastasis from the known malignant pleural mesothelioma
  • The patient died shortly after the diagnosis
• The authors' conclusion: The authors concluded that radiotherapy might lead to an 'isoradiotropic response', in which cutaneous metastasis preferentially appears on irradiated skin. They said clinicians should watch for cutaneous involvement in patients with malignant mesothelioma, especially on irradiated areas.

Topics

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

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