Mesothelioma - "not just in the chest"

Our plain-English summary of Mesothelioma - "not just in the chest", by C.E. Bruckner Holt, A.D. Farmer, W. Syn, et al (The Ulster Medical Journal, 2008).

The study

• Authors: C.E. Bruckner Holt, A.D. Farmer, W. Syn, T. Shah, G. Townson
• Journal: The Ulster Medical Journal
• Published: 2008;77(2):133-4
• Type of article: Case report, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Free full text

In plain English

This letter reported a single case of malignant deciduoid mesothelioma, which the authors described as a rare form of epithelioid mesothelioma most often found in the abdominal lining (peritoneum) of young women. The patient was a previously healthy 31-year-old woman with growing abdominal swelling and shortness of breath. She smoked 15 cigarettes a day and had no prior history of asbestos exposure. Fluid drawn from her abdomen showed no evidence of bacterial or mycobacterial infection, and its cells looked like benign reactive mesothelial cells. A chest X-ray showed no pleural plaques or effusions, and scans showed no chest lesions. Laparoscopy drained 9 litres of fluid and found many small nodules around the small bowel. Routine tissue stains could not tell benign from cancerous disease. After expert opinion was sought, staining for calretinin and cytokeratin supported the diagnosis. She received pemetrexed and cisplatin chemotherapy, needed repeated fluid drainage, and died 14 months after diagnosis. The authors concluded that the disease shows how hard benign and malignant disease can be to tell apart. They wrote that the case highlights the usefulness of diagnostic laparoscopy for unexplained abdominal fluid.

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 previously healthy 31-year-old woman with increasing abdominal girth and shortness of breath, treated at Princess Royal Hospital, Telford, UK
• Exposure: the patient smoked 15 cigarettes per day and had no prior history of asbestos exposure
• Main results:
  • Fluid drawn from the abdomen showed no evidence of bacterial or mycobacterial infection; its cells looked like benign reactive mesothelial cells
  • Chest radiograph showed no pleural plaques or effusions; scans showed no thoracic lesions
  • Diagnostic laparoscopy drained 9 litres of ascites and found numerous small nodules around the small bowel
  • Conventional stains of the nodules could not distinguish benign reactive from neoplastic disease
  • Immunostaining showed strong positivity for calretinin and cytokeratin, consistent with malignant deciduoid mesothelioma
  • The patient was treated with pemetrexed and cisplatin, needed repeated abdominal paracentesis, and died 14 months after diagnosis
• The authors' conclusion: The authors concluded that malignant deciduoid mesothelioma illustrates the difficulty of telling benign from malignant disease, and that the case highlights the usefulness of diagnostic laparoscopy in investigating unexplained ascites

Topics

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

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

Related studies

• Collagenous Spherulosis in Well-Differentiated Papillary Mesothelioma in a Female With Multilocular Peritoneal Inclusion Cysts — B. AbdullGaffar, L.G. Raman (2019)
• The Its Not JUST Idiopathic pulmonary fibrosis Study (INJUSTIS): description of the protocol for a multicentre prospective observational cohort study identifying biomarkers of progressive fibrotic lung disease — F. Khan, I. Stewart, et al. (2019)
• Peritoneal mesothelioma — W.J. Plaus (1988)
• Papillary mesothelioma of the peritoneum in the absence of asbestos exposure — T. Meister, T. Birkfellner, et al. (2003)
• Pediatric Benign Cystic Peritoneal Mesothelioma — J. Durell, H. Dagash, et al. (2016)
• Remote Recurrence of Benign Multicystic Peritoneal Mesothelioma — C.E. Lee, A. Agrawal (2017)

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