Desmoplastic malignant mesothelioma of the peritoneum

Our plain-English summary of Desmoplastic malignant mesothelioma of the peritoneum, by B. Badak, O. Turk, E. Ates, et al (Oxford Medical Case Reports, 2014).

The study

• Authors: B. Badak, O. Turk, E. Ates, D. Arik
• Journal: Oxford Medical Case Reports
• Published: 2014;2014(3):49-51
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma is an uncommon neoplasm arising in body cavities lined by the mesothelium. Immunohistochemical stains are useful for making a diagnosis, but the correct combination of antibodies as should be selected in a comprehensive assessment. A peritoneal origin combined with desmoplastic histology is an extremely rare disease entity. Here, we report a case of the primary peritoneal malignant mesothelioma. A 53-year-old man admitted to the hospital with abdominal distension and pelvic pain. In laparotomy, peritonitis carcinomatosa situation was exposed. Multiple biopsies were taken from omentum, peritoneum and fascia. Calretinin, WT-1, D2-40, keratin 5/6, mesothelin, keratin 7, keratin 20, CD99, CEA, smooth muscle actin, desmin, CD34 and S-100 were negative. With these findings tumor was evaluated as desmoplastic malignant mesothelioma of the peritoneum. Currently, no established standard treatments for malignant peritoneal mesothelioma, but early diagnosis by exploratory laparotomy followed by chemotherapy may have contributed to longer survival for patients.

In plain English

This article is a case report from Turkey about one patient. A 53-year-old man from a rural area of Eskisehir came to hospital with a swollen abdomen and abdominal and pelvic pain. His medical history, including chest symptoms and asbestosis, was unremarkable. The authors wrote that he did not live in an area exposed to asbestos. Fluid was found in his abdomen. CT and MRI scans showed a fluid collection measuring 27 cm by 13 cm by 19 cm and two 9 mm nodules on the liver. A chest X-ray and chest CT did not suggest pleural mesothelioma. At surgery, the surgeons found widespread tumor in the abdominal lining and took biopsies. Under the microscope, scattered abnormal tumor cells lay in dense fibrous tissue. The cells stained positive for cytokeratin, vimentin and thrombomodulin and negative for many other markers, including calretinin, WT-1 and D2-40. The tumor was diagnosed as desmoplastic malignant mesothelioma of the peritoneum, which the authors described as a subtype of sarcomatoid mesothelioma. The authors considered the case unusual for its abdominal location and rare subtype. The report does not describe this patient's treatment or outcome.

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 (one patient)
• Who was studied: one 53-year-old man from a rural area of Eskisehir, Turkey, who had abdominal distension and abdominopelvic pain
• Exposure: No asbestos exposure was identified. His history, including asbestosis, was unremarkable, and the authors state he did not live in an asbestos-exposed area. No fiber type is named.
• Main results:
  • CT and MRI showed a fluid collection measuring 27 cm craniocaudal, 13 cm mediolateral and 19 cm anteroposterior, with an enhancing wall and internal septation
  • CT and MRI also showed two 9 mm nodules in segment 5 of the liver
  • Chest CT showed nothing abnormal, and the chest X-ray did not suggest pleural mesothelioma
  • Exploratory laparotomy found peritonitis carcinomatosa (widespread tumor in the abdominal lining), and biopsies were taken from the omentum, peritoneum and fascia
  • Biopsies showed few infiltrating atypical tumor cells with spindle, triangular or polygonal shapes in large areas of hyalinized collagenous tissue
  • On immunohistochemistry the tumor cells were positive for cytokeratin, vimentin and thrombomodulin
  • Calretinin, WT-1, D2-40, keratin 5/6, mesothelin, keratin 7, keratin 20, CD99, CEA, smooth muscle actin, desmin, CD34 and S-100 were negative, and there was no mucin with Alcian blue
• The authors' conclusion: The authors evaluated the tumor as desmoplastic malignant mesothelioma of the peritoneum and considered the case interesting because of its abdominal location and rare histological subtype. They also wrote, as a general statement rather than a finding in this patient, that early diagnosis by exploratory laparotomy followed by chemotherapy may contribute to longer survival.

Topics

Medical terms in this study, explained in our Lexicon: Desmoplastic Mesothelioma, Mesothelioma, Peritoneum, Neoplasm, Mesothelium, Histology, Laparotomy, Omentum.

Related studies

• Desmoplastic malignant mesothelioma originating from the peritoneum — H. Takamaru, Y. Arimura, et al. (2012)
• Case report: Radiological features of a case of desmoplastic malignant mesothelioma of peritoneum — J. Wang, H. Deng (2024)
• BAP1 Immunohistochemistry and p16 FISH in the Diagnosis of Sarcomatous and Desmoplastic Mesotheliomas — H.C. Hwang, S. Pyott, et al. (2016)
• The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining — W.E. Mangano, P.T. Cagle, et al. (1998)
• GATA3 Immunohistochemistry for Distinguishing Sarcomatoid and Desmoplastic Mesothelioma From Sarcomatoid Carcinoma of the Lung — K.B. Berg, A. Churg (2017)
• Keratin and epithelial membrane antigen immunoreactivity in nonneoplastic fibrous pleural lesions: implications for the diagnosis of desmoplastic mesothelioma — J.I. Epstein, R.E. Budin (1986)

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