Malignant Peritoneal Mesothelioma Mimicking Ischemic Colitis

Our plain-English summary of Malignant Peritoneal Mesothelioma Mimicking Ischemic Colitis, by Y. Mitsuka, S. Yamazaki, T. Miyakuni, et al (Case Reports in Gastroenterology, 2010).

The study

• Authors: Y. Mitsuka, S. Yamazaki, T. Miyakuni, A. Iwama, T. Funada, Y. Watanabe, T. Kaiga, S. Okada, M. Kochi, T. Takayama
• Journal: Case Reports in Gastroenterology
• Published: 2010;4(2):238-242
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

The prognosis of malignant peritoneal mesothelioma is extremely poor with a mean survival time of 12 months. The initial symptoms are poor and atypical. Because of its rare entity and little knowledge of its treatments, there are few reports of long-term survival. We encountered a very unique case with strong impression on radiological findings of malignant peritoneal methothelioma. We had misdiagnosed it because of the findings and because the time course was similar to that of ischemic colitis. The radiological findings on CT and enema disappeared within one week after antibiotic therapy.

In plain English

This article was a case report from the Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan. It described a 74-year-old woman with malignant peritoneal mesothelioma, a cancer of the abdominal lining, who the authors said had no history of asbestos exposure. She first went to a local clinic with lower abdominal pain, melena (bloody stool) and low-grade fever. She was diagnosed with ischemic colitis, and her scan findings and inflammation improved within one week of antibiotics. Four months later she was referred with abdominal symptoms that came and went. A CT scan showed a 50-mm tumor, and surgery was done for a suspected gastrointestinal stromal tumor. At operation there was mucous fluid, many small scattered lesions, and a 54-mm tumor in the mesentery of the small intestine. Mesothelioma was confirmed by a hyaluronic acid level of 625,000 ng/ml in the abdominal fluid. After monthly chemotherapy with CDDP and VP-16, she had no new lesions, no rise in tumor markers and no ascites for 2 years. The authors concluded this regimen after reduction surgery may be a powerful option. The report describes one patient.

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 74-year-old woman, first seen at a local clinic and later treated at Nihon University School of Medicine, Tokyo, Japan
• Exposure: The authors stated the patient had no asbestos exposure history
• Main results:
  • The patient was first diagnosed with ischemic colitis; scan findings and inflammatory response improved within one week of antibiotic therapy
  • Four months later, the patient's serum CA125 had risen to 202 U/ml
  • Pelvic CT showed a 50-mm tumor with a small amount of ascites, and surgery was performed under a diagnosis of gastrointestinal stromal tumor
  • At operation, a 54-mm tumor involved the mesentery of the small intestine, with a large volume of mucous ascites and scattered small disseminated lesions
  • On immunohistochemistry, CD34 and C-kit were negative, while keratin, vimentin and EMA were positive
  • The diagnosis of malignant peritoneal mesothelioma was confirmed by a hyaluronic acid level of 625,000 ng/ml in the ascites sample
  • With monthly adjuvant CDDP and VP-16, the patient had no new lesions, no tumor marker rise and no ascites for 2 years, and remained alive over 2 years after surgery
• The authors' conclusion: The authors concluded that CDDP plus VP-16 chemotherapy following reduction surgery may be a powerful option for malignant peritoneal mesothelioma

Topics

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

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