Mesothelioma of the Peritoneum

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

The study

• Authors: H. Nanjarajiah, J.P. Goravalingappa, S.B. Nargund, G.S. Denesgbabu, J.H. Makannavar
• Published: Indian Medical Association Journal 72(1):15-17 January (1979)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was a case report of one man with peritoneal mesothelioma, a tumour of the lining of the abdomen. He was admitted to the K.M.C. Hospital, Hubli, on 31 January 1977 with central abdominal pain lasting 2 years and swelling of both legs for one month. At exploratory surgery the surgeons found about 500 ml of straw-coloured fluid and many firm nodules, up to 2 cm across, on the bowel, the tissues around it and the surface of the liver. Two narrowed segments of small bowel were bypassed. Tuberculosis was first presumed and treated, but tissue examination showed a malignant tumour consistent with diffuse mesothelioma. He was given cyclophosphamide into the abdominal cavity, 1 g, and the dose was repeated a month later. A week after that he died of sudden severe bleeding in the upper digestive tract, and no autopsy was done. The authors reported that he had no history of exposure to asbestos dust and did not cultivate sugar cane. They noted that this diagnosis is rarely suspected before surgery and must be distinguished from tuberculous peritonitis and from secondary carcinomatosis of the peritoneum.

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 man admitted to the K.M.C. Hospital, Hubli, on 31-1-1977 (age printed illegibly in the scanned text)
• Exposure: The authors reported no history of exposure to asbestos dust. The patient also did not cultivate sugar cane.
• Main results:
  • At laparotomy the surgeons found about 500 ml of straw-coloured fluid. Multiple greyish-yellow firm nodules up to 2 cm studded the mesentery, greater omentum, intestines and visceral surface of the liver.
  • Antituberculosis treatment was started after surgery because tuberculosis was presumed. It was stopped after 20 days, when mesothelioma was diagnosed.
  • Histopathology of omental nodules showed a malignant tumour consistent with diffuse mesothelioma.
  • A later biopsy of the subcutaneous umbilical nodules showed mesothelioma with the same features.
  • The patient died of sudden severe upper gastro-intestinal haemorrhage a week after the second 1 g dose of intraperitoneal cyclophosphamide. Autopsy was not possible.
  • The patient received a total of 2 g of cyclophosphamide and died of the disease within 2 years of the onset of symptoms.
• The authors' conclusion: The authors concluded that a pre-operative diagnosis of peritoneal mesothelioma is rarely considered and is often made at laparotomy. They wrote that the condition must be distinguished from tuberculous peritonitis and from secondary carcinomatosis of the peritoneum. They attributed the patient's improvement after surgery to relief of the bowel obstruction by the bypass, not to the antituberculosis drugs.

Topics

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

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