Late cutaneous metastases to the face from malignant pleural mesothelioma: a case report and review of the literature

Our plain-English summary of Late cutaneous metastases to the face from malignant pleural mesothelioma: a case report and review of the literature, by A.M. Elbahaie, D.E. Kamel, J. Lawrence, et al (World Journal of Surgical Oncology, 2009).

The study

• Authors: A.M. Elbahaie, D.E. Kamel, J. Lawrence, N.G. Davidson
• Journal: World Journal of Surgical Oncology
• Published: 2009;7:84
• Type of article: Case report, Review
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant Mesothelioma is a rare primary neoplasm affecting the serosal membranes. During its relative short course, this malignant neoplasm can give local and, rarely, distant haematogenous metastases in different organs. The reported metastatic sites include liver, lung, heart, brain, thyroid, adrenals, kidneys, pancreas, bone, soft tissue, skin and lymph nodes.

Case Presentation: We report a sixty one year-old man with a history of malignant pleural epithelioid mesothelioma treated with six cycles of Pemetrexed and Carboplatin completed 03/11/04 followed by radiotherapy to the drain site 250 Kv/TD20Gy/5F completed 13/12/2004. Then he developed multiple facial skin lesions 4 years later. These lesions were proved to be metastatic malignant sarcomatoid mesothelioma.

Conclusion: Mesothelioma metastases should be suspected in any known Mesothelioma patient with newly developed skin lesion.

In plain English

This article is a case report with a short review of earlier published cases. It described a 61-year-old white man, a non-smoker and semi-retired boat builder with what the authors called a significant asbestos exposure history; no fiber type was named. In June 2004 a biopsy showed malignant pleural mesothelioma of the epithelioid type. In a trial he received six cycles of pemetrexed and carboplatin, ending 3 November 2004, then radiotherapy to the drain site. He had no signs of disease until late December 2007, when a lump appeared on his right cheek. A March 2008 CT scan showed recurrence in the right chest and right para-renal space. Three skin lesions, on the right cheek, behind the right ear and on the forehead, proved to be sarcomatous-type metastatic mesothelioma, though the chest recurrence was still epithelioid. The authors found 10 previously reported cases, in English-language articles, of pleural mesothelioma with distant subcutaneous spread; seven involved the face or scalp. They concluded that mesothelioma spread should be suspected in any known mesothelioma patient with a new malignant skin lesion. The patient later died.

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 one patient, with a brief review of previously published cases
• Who was studied: One 61-year-old white man with pleural mesothelioma, a non-smoker, followed by the authors' hospital services in Essex, UK, from 2004 to 2008
• Exposure: Work as a boat builder with a significant history of asbestos exposure. No fiber type or dose was given.
• Main results:
  • A biopsy on 8 June 2004 showed malignant mesothelioma of the epithelioid type
  • The patient received 6 cycles of pemetrexed 500 mg/m2 plus carboplatin, with the last cycle on 3 November 2004
  • The patient had no evidence of disease recurrence until the end of December 2007, when he noticed a lesion on his right cheek. The authors described this as more than 37 months of disease-free survival.
  • A CT scan on 17 March 2008 showed recurrence in the right hemithorax and right para-renal space
  • Three skin lesions were found on the face, including a 24 by 24 mm lesion on the right cheek
  • Biopsies of the skin lesions were diagnosed as metastatic mesothelioma of sarcomatous type
  • The original tumour and the chest recurrence were epithelioid, while the skin metastases were sarcomatous
  • In their literature review, the authors found 10 previously reported cases, in English-language published articles, of pleural mesothelioma with distant subcutaneous metastases. Seven of those cases involved the face and/or scalp.
  • The patient died before publication. Consent was given by his widow.
• The authors' conclusion: The authors concluded that metastatic mesothelioma should be suspected in any known mesothelioma patient who develops a new malignant skin lesion. They expected the number of recorded distant skin metastases to increase.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma, Neoplasm, Epithelioid, Pemetrexed (Alimta), Carboplatin, Sarcomatoid.

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