Malignant peritoneal mesothelioma diagnosed by EUS-guided tissue acquisition

Our plain-English summary of Malignant peritoneal mesothelioma diagnosed by EUS-guided tissue acquisition, by D. Mohri, Y. Nakai, H. Isayama, et al (Endoscopic Ultrasound, 2015).

The study

• Authors: D. Mohri, Y. Nakai, H. Isayama, K. Koike
• Journal: Endoscopic Ultrasound
• Published: 2015;4(4):353-4
• Type of article: Letter
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This letter to the editor described one patient, a 73-year-old man, whose recurrent malignant peritoneal mesothelioma was diagnosed using endoscopic ultrasound (EUS)-guided tissue sampling. Five years earlier, during surgery for sigmoid colon cancer, a 17-mm nodule was removed from the omentum and diagnosed as malignant mesothelioma. The article stated that the patient had not been exposed to asbestos. Follow-up CT scans every 6 months showed no recurrence, until a CT showed a 3-cm, ill-defined soft tissue mass around the second portion of the duodenum. A PET scan showed uptake with a maximum SUV of 10.5. The duodenal lining looked normal on endoscopy, and a biopsy there was negative. EUS showed a mass infiltrating the liver and duodenum. Samples were taken through a 19-gauge needle, first with miniature biopsy forceps and then by fine-needle aspiration. They stained positive for calretinin and cytokeratin 5/6 and negative for CEA and CDX-2, which confirmed recurrent malignant mesothelioma. The authors concluded that EUS-guided tissue acquisition should be the first diagnostic procedure, rather than laparoscopy or laparotomy. As a single case, it cannot show how often the method succeeds.

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 (letter to the editor)
• Who was studied: one 73-year-old man with a history of sigmoid colon cancer 5 years earlier
• Exposure: The article states the patient had not been exposed to asbestos. No fiber type or job is described.
• Main results:
  • A 17-mm omental nodule was incidentally removed at the patient's earlier sigmoid colon surgery and diagnosed as malignant mesothelioma
  • CT surveillance every 6 months after surgery showed no recurrence, until a CT showed a 3-cm, ill-defined soft tissue mass surrounding the second portion of the duodenum
  • FDG-PET showed FDG accumulation with a maximum SUV of 10.5
  • The duodenal mucosa appeared normal on endoscopy, and the biopsy was negative
  • EUS showed a hypoechoic mass infiltrating both the liver and the duodenum
  • Through-the-needle forceps biopsies were followed by a single-pass fine-needle aspiration
  • The tissue stained positive for calretinin and cytokeratin 5/6 and negative for CEA and CDX-2, confirming recurrent malignant mesothelioma
• The authors' conclusion: The authors concluded that EUS-guided tissue acquisition should be the first diagnostic procedure, rather than invasive procedures such as laparoscopy and/or laparotomy

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma.

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