Laparoscopy and mesothelioma

Our plain-English summary of Laparoscopy and mesothelioma, by J.C. Stamat, E.G. Chekan, A. Ali, et al (Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a, 1999).

The study

• Authors: J.C. Stamat, E.G. Chekan, A. Ali, A. Ko, T.A. Sporn, W.S. Eubanks
• Journal: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
• Published: 1999;9(5):433-7
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is a well-recognized long-term sequela of chronic asbestos exposure. Asbestos use in the United States began in the 1950s and was widespread until the mid-1970s. Although currently only 2.2 cases per million population per year are diagnosed, disease incidence is increasing because of the long latency of this neoplasm. A latency of 15-50 years means that a higher incidence of this neoplasm can be anticipated in the future. The authors report a patient with peritoneal mesothelioma and no known prior exposure to asbestos. The diagnosis was confirmed by exploratory laparoscopy, which entailed biopsies of the diaphragm and of the peritoneal and abdominal walls, and by cytologic evaluation of 700 ml ascitis fluid. At present, exploratory laparoscopy offers the quickest, safest, and least invasive way to confirm the clinical diagnosis of peritoneal malignant mesothelioma.

In plain English

This article was a case report by authors from the surgery and pathology departments at Duke University Medical Center. It described a 66-year-old man who had abdominal discomfort, a growing abdomen, low energy and a 30-pound weight loss over three months. The authors reported that he had no known prior exposure to asbestos. He had traveled widely for his work. Fluid drained from his abdomen contained atypical cells that were consistent with, but not diagnostic of, cancer. Exploratory laparoscopy (keyhole surgery of the abdomen) found tumor spread over all peritoneal surfaces and solid organs, and about 700 ml of fluid was drained. Three peritoneal masses were removed, and tissue staining confirmed malignant mesothelioma. He went home on the second day after surgery. During eight weeks of chemotherapy with CPT-11, his CA-125 blood marker fell from 550 to 446 and then rose to 620, and his abdomen stayed swollen. The authors concluded that exploratory laparoscopy offers the quickest, safest and least invasive way to confirm a diagnosis of peritoneal malignant mesothelioma. The report describes one patient only.

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 (single patient)
• Who was studied: One 66-year-old white man with abdominal symptoms; the authors are from Duke University Medical Center, Durham, North Carolina; dates not given
• Exposure: No known prior asbestos exposure; no fiber type or job exposure reported. The patient traveled extensively for his profession.
• Main results:
  • Before surgery, fluid drained from the patient's abdomen showed atypical cells that suggested, but did not establish, cancer
  • At exploratory laparoscopy, about 700 ml of mucinous, green ascitic fluid was drained
  • Three peritoneal masses were excised, and immunostaining confirmed malignant mesothelioma in this patient
  • The patient recovered without complications and went home on the second day after surgery
  • During 8 weeks of CPT-11 chemotherapy, the patient's CA-125 dropped from 550 to 446 and then rose to 620; his abdomen remained distended
• The authors' conclusion: The authors concluded that exploratory laparoscopy currently offers the quickest, safest, and least invasive way to confirm the clinical diagnosis of peritoneal malignant mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Sequela, Asbestos Exposure, Latency, Neoplasm, Peritoneal Mesothelioma, Diaphragm.

Related studies

• Value of laparoscopy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis — L.H. Iversen, P.C. Rasmussen, et al. (2013)
• Laparoscopy is Safe and Accurate to Evaluate Peritoneal Surface Metastasis Prior to Cytoreductive Surgery — R.A. Marmor, K.J. Kelly, et al. (2016)
• Diagnostic Laparoscopy Improves Staging of Malignant Pleural Mesothelioma With Routine Positron Emission Tomography Imaging — R.T. Ripley, N. Palivela, et al. (2021)
• Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies — G. Passot, N. Bakrin, et al. (2014)
• Long-term results of laparoscopic cytoreductive surgery and HIPEC for the curative treatment of low-grade pseudomyxoma peritonei and multicystic mesothelioma — F. Mercier, G. Jeremie, et al. (2020)
• Laparoscopic diagnosis and treatment of pelvic benign multicystic mesothelioma associated with high CA19.9 serum concentration — V. Pinto, A.C. Rossi, et al. (2010)

Browse return to medical research.