Localized malignant mesothelioma in the stomach and mediastinum

Our plain-English summary of Localized malignant mesothelioma in the stomach and mediastinum, by T.D. Jeppesen, A. Højsgaard, D. Kjær, et al (Interactive Cardiovascular and Thoracic Surgery, 2022).

The study

• Authors: T.D. Jeppesen, A. Højsgaard, D. Kjær, T.D. Christensen
• Journal: Interactive Cardiovascular and Thoracic Surgery
• Published: 2022;34(3):485-487
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Localized malignant mesothelioma is rare. It has a histological pattern identical to diffuse malignant mesothelioma but without diffuse serosal spread. Localized malignant mesothelioma typically originates from the pleura, peritoneum or pericardium, but can occasionally develop from organs. Our cases represent what might be the largest mediastinal localized malignant mesothelioma described and the first presentation of the epithelioid type in the stomach of an adult.

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

In plain English

This brief report from Aarhus University Hospital, Denmark, described two patients with localized malignant mesothelioma, a rare form that lacks diffuse spread along body linings. The first, a 66-year-old man previously exposed to asbestos, had a tumour along the right side of the heart. A biopsy was read as adenocarcinoma, and at surgery the tumour was found to extend into the abdomen. After removal, tissue analysis showed malignant epithelioid mesothelioma, assumed to arise in the mediastinum (the central chest). Tumour cells were found at the diaphragm margins, and he received 3 of 6 planned chemotherapy cycles. The disease recurred 6 months after surgery, and after further treatment his symptoms improved. The second patient, a 74-year-old woman and former smoker, had a 5-cm epithelioid mesothelioma next to the upper part of the stomach. The report does not mention asbestos exposure for her. After chemotherapy and surgery with clear margins, she was recurrence-free 22 months later. The authors concluded that mesothelioma should be considered for a solid tumour regardless of gender, asbestos exposure and organ of origin.

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 (two cases, brief communication)
• Who was studied: Two patients treated at Aarhus University Hospital, Denmark: a 66-year-old male non-smoker and a 74-year-old female former smoker; dates of treatment not given
• Exposure: Case 1 was described only as previously asbestos-exposed, with no fiber type, job or dose given. No asbestos exposure is mentioned for Case 2, who was a former smoker.
• Main results:
  • Case 1 (66-year-old man): the preoperative biopsy was read as adenocarcinoma, and the tumour was first considered a primary lung cancer
  • Case 1: the chest tumour continued into a large component inside the abdomen, without involving the right lung
  • Case 1: after resection, histology showed malignant epithelioid mesothelioma, assumed to derive from the mediastinum
  • Case 1: the diaphragm resection margins contained tumour cells; adjuvant chemotherapy was planned as 6 cycles, but only 3 were given because of neutropenia
  • Case 1: recurrent disease was detected on CT 6 months after surgery, leading to more chemotherapy and palliative radiotherapy
  • Case 1: after palliative radiotherapy, 22 months after surgery, symptoms improved and he resumed daily activities; he is now in an experimental oncological treatment project
  • Case 2 (74-year-old woman): an endoscopic ultrasound biopsy of a 5-cm tumour near the fundus of the stomach showed malignant mesothelioma, epithelioid type
  • Case 2: 6 cycles of carboplatin/pemetrexed before surgery shrank the tumour by 1 cm
  • Case 2: after surgery, histology confirmed epithelioid malignant mesothelioma with clear resection margins, and she remained recurrence-free 22 months after surgery
• The authors' conclusion: The authors concluded that their cases may be the largest localized mediastinal mesothelioma described and the first epithelioid localized mesothelioma originating in the stomach of an adult. They said the cases highlight the importance of considering mesothelioma in the differential diagnosis of a solid tumour, regardless of gender, asbestos exposure and especially organ of origin.

Topics

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

Medical terms in this study, explained in our Lexicon: Localized Malignant Mesothelioma, Mediastinum, Mesothelioma, Pleura, Peritoneum, Pericardium, Epithelioid.

Related studies

• Localized malignant pleural mesothelioma showing a thoracic mass and metastasizing to the stomach — H. Hayashi, K. Notohara, et al. (2010)
• Primary Localized Peritoneal Malignant Mesothelioma Involving the Stomach and Transverse Colon: A Case Report — S.R. Ahn, J.H. Lee (2025)
• Solitary fibrous tumor of the mediastinum — N. Weidner (1991)
• Salvage debulking surgery and hyperthermic intrathoracic chemotherapy for massive recurrent mesothelioma in the mediastinum — S.S. Poon, C. Alberti, et al. (2022)
• Solitary fibrous tumor of the mediastinum. A report of 14 cases — G.B. Witkin, J. Rosai (1989)
• A biphasic tumor of the mediastinum with features of synovial sarcoma. A report of four cases — G.B. Witkin, M. Miettinen, et al. (1989)

Browse more research in Interactive Cardiovascular and Thoracic Surgery, or return to medical research.