\[Malignant mesothelioma of the ovary: a case report\]

Our plain-English summary of [Malignant mesothelioma of the ovary: a case report], by I. Ouafki, L. Nouiakh, R. Boujarnija, et al (The Pan African Medical Journal, 2021).

The study

• Authors: I. Ouafki, L. Nouiakh, R. Boujarnija, A. Amarti, L. Amaadour, K. Oualla, Z. Benbrahim, S. Arifi, N. Mellas
• Journal: The Pan African Medical Journal
• Published: 2021;38:92
• Type of article: Case report
• Language: French
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Primary malignant mesothelioma of the ovary (PMMO) is an extremely rare tumor which can develop from mesothelial cells. This neoplasia is caused predominantly by exposure to asbestos or other cancer-causing agents. Preoperative assessment, based on computed tomography (CT) scan, magnetic resonance imaging and positron emission tomography, is essential for cancer staging. Anatomopathological diagnosis is based on immunohistochemical findings. PMMO is an exceptional disease involving a multidisciplinary therapeutic strategy including the use of chemotherapy which improves the management and prognosis of patients. This study reports the case of a female patient undergoing suboptimal surgery complemented by adjuvant chemotherapy with complete radiological response and 1-year disease-free survival.

Copyright: Imane Ouafki et al.

In plain English

This French-language case report described one patient, a 50-year-old woman treated in Fès, Morocco, for a large abdominal and pelvic mass. At surgery the mass, measuring 30 cm by 40 cm, arose from the left ovary; the uterus, both ovaries and tubes were removed and biopsies taken. Tumour cells stained positive for markers including calretinin and cytokeratin 7, weakly positive for Ber-EP4, and negative for WT1, EMA and cytokeratin 5/6, and ovarian mesothelioma was diagnosed. After surgery a scan showed no remaining disease and the blood marker CA125 fell from 233 to 21.40 U/ml. She received 6 cycles of gemcitabine and carboplatin, with one episode of neutropenia without fever, and was in good control after more than 12 months. The authors reported that she had no history of occupational asbestos exposure, being a housewife, and no history of radiotherapy. The authors concluded that primary malignant mesothelioma of the ovary is exceptional and that further studies are needed for early and correct diagnosis.

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 50-year-old woman with many previous pregnancies, with heart failure from stable ischemic heart disease and controlled high blood pressure, treated at the Centre Hospitalier Universitaire Hassan II, Fès, Morocco
• Exposure: No asbestos exposure was identified. The authors reported a negative history of occupational asbestos exposure, since she was a housewife, and no history of radiotherapy.
• Main results:
  • Before surgery, the patient's CA125 was 233 U/ml. CEA and CA19-9 were normal.
  • At exploratory laparotomy, a 30 cm x 40 cm mass arising from the left ovary was found.
  • The tumour cells expressed CK7, calretinin, focally inhibin, vimentin, P53, CK8/18, CK19 and CK20.
  • WT1 staining was negative in this patient. Ber-EP4 was weakly positive.
  • The final diagnosis was ovarian mesothelioma.
  • The postoperative CT scan showed no residual disease, and CA125 fell to 21.40 U/ml.
  • The patient received 6 cycles of adjuvant chemotherapy (gemcitabine plus carboplatin). One episode of non-febrile neutropenia occurred.
  • At follow-up of more than 12 months, the patient was in good control.
• The authors' conclusion: The authors concluded that primary involvement of the ovaries by malignant mesothelioma is exceptional, with only a few cases reported, and that further studies are needed for early and correct diagnosis.
• Limitations the authors state:
  • The authors reported that inhibin and anti-Müllerian hormone (AMH) were not measured because reagents were lacking.
  • The authors reported that pemetrexed was not available at their facility at the time of the first chemotherapy cycle.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Mesothelial Cells, Staging, Chemotherapy, Prognosis, Disease-Free Survival.

Related studies

• Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary; case report — M. Swerdlow (1959)
• Keratins 7 and 20 as diagnostic markers of carcinomas metastatic to the ovary — C.C. Wauters, F. Smedts, et al. (1995)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Talc and carcinoma of the ovary and cervix — W.J. Henderson, C.A. Joslin, et al. (1971)
• Expression of calretinin in human ovary, testis, and ovarian sex cord-stromal tumors — Q.J. Cao, J.G. Jones, et al. (2001)
• An ultrastructural comparison of mesotheliomas and adenocarcinomas of the ovary and endometrium — M.J. Warhol, N.J. Hunter, et al. (1982)

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