Mesothelioma of the peritoneum

Our plain-English summary of Mesothelioma of the peritoneum, by H. Nanjarajiah, J.P. Goravalingappa, S.B. Nargund, et al (Journal of the Indian Medical Association, 1979).

The study

• Authors: H. Nanjarajiah, J.P. Goravalingappa, S.B. Nargund, G.S. Deneshbabu, J.H. Makannavar
• Journal: Journal of the Indian Medical Association
• Published: 1979;72(1):15-7
• Type of article: Case report
• Read it: PubMed

In plain English

This is a case report of one patient with peritoneal mesothelioma, treated at a hospital in Hubli, India. A 55-year-old man was admitted in January 1977 with central abdominal pain of 2 years' duration and swelling of both legs for one month. The authors reported that he had no history of exposure to asbestos dust and did not cultivate sugar cane. At exploratory surgery in March 1977, surgeons found about 500 ml of fluid and many firm nodules up to 2 cm on the omentum, intestines and liver surface, resembling tubercles. Tuberculosis was presumed and anti-tuberculosis drugs were started. Microscopic examination of two removed nodules showed a malignant tumour consistent with diffuse mesothelioma, and the tuberculosis treatment was stopped after 20 days. He received two 1 g doses of cyclophosphamide into the abdominal cavity, about a month apart. Nodules under the skin near the navel also showed mesothelioma. A week later he died of sudden severe upper gastrointestinal bleeding, about 2 years after symptoms began. No autopsy was possible. The authors concluded that this tumour is rarely suspected before surgery and needs to be distinguished from tuberculous peritonitis and secondary peritoneal cancer.

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), with a brief review of the literature
• Who was studied: one 55-year-old man, admitted to K.M.C. Hospital, Hubli (Karnatak Medical College and Hospital), India, on 31-1-1977
• Exposure: The authors reported no history of asbestos dust exposure. They also noted that he did not cultivate sugar cane, which another report cited in the discussion had linked to pleural mesothelioma.
• Main results:
  • The patient presented with central abdominal pain of 2 years' duration and swelling of the lower limbs for one month.
  • At exploratory laparotomy, about 500 ml of straw-coloured fluid was found, and the omentum, intestines and visceral surface of the liver were studded with firm nodules up to 2 cm resembling tubercles.
  • After surgery the diagnosis was presumed to be tuberculosis and anti-tuberculosis treatment was given. It was stopped after 20 days when the mesothelioma diagnosis was established.
  • Pathology of two omental nodules showed a malignant tumour consistent with diffuse mesothelioma.
  • Subcutaneous nodules in the umbilical region, biopsied at follow-up, showed mesothelioma with the same features.
  • The patient received only 2 g of cyclophosphamide in total, given into the peritoneal cavity in two 1 g doses.
  • A week after the second dose he died of sudden, severe upper gastrointestinal haemorrhage, about 2 years after onset of symptoms. No autopsy was possible.
• The authors' conclusion: The authors stated that a pre-operative diagnosis of peritoneal mesothelioma is rarely considered. They said the condition needs to be distinguished from tuberculous peritonitis and from secondary carcinomatosis of the peritoneum, and that suspected cases should be fully investigated for tuberculosis and searched for a primary adenocarcinoma. They also attributed the patient's post-operative improvement to the relief from surgery, not to the anti-tuberculosis drugs.

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, Peritoneum.

Related studies

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• Papillary tumors of the peritoneum in women: mesothelioma or papillary carcinoma — M. Kannerstein, J. Churg, et al. (1977)
• 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)
• Neoplastic and inflammatory processes of the peritoneum, omentum, and mesentery: diagnosis with CT — J.E. Hamrick-Turner, M.V. Chiechi, et al. (1992)
• Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases — U. Raju, G. Fine, et al. (1989)

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