Metastatic malignant pleural mesothelioma masquerading as a case of acute abdomen secondary to small bowel perforation

Our plain-English summary of Metastatic malignant pleural mesothelioma masquerading as a case of acute abdomen secondary to small bowel perforation, by K. Alkhayal (Annals of Saudi Medicine, 2016).

The study

• Author: K. Alkhayal
• Journal: Annals of Saudi Medicine
• Published: 2016;36(3):229-31
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Unlabelled: Metastatic pleural mesothelioma is a rare disease. The present study aimed to report a rare presentation of metastatic malignant mesothelioma (MM). The patient was an elderly man who presented with small bowel (jejunal) perforation secondary to metastatic pleural mesothelioma deposits. This was a rare presentation of a rare disease and the first reported case in the published studies in which MM masqueraded as bowel perforation prior to the primary diagnosis.

Similar Cases Published: 1.

In plain English

This article was a case report from the Department of Surgery at King Saud University in Riyadh, Saudi Arabia. It described a 65-year-old man, a heavy smoker for 40 years, who came to the emergency department with one week of lower abdominal pain that had become generalized, with fever and vomiting. A chest x-ray showed air under the diaphragm and a mass on the right side of the chest. A CT scan described a 4.8×8 cm mass arising from the right chest wall. During an exploratory operation, four masses were found on the jejunum (part of the small bowel), along with another mass that had perforated. Sixty centimetres of small bowel were removed. Tissue examination showed nodules of a highly malignant epithelioid tumor, and the tumor cells stained positive for calretinin and podoplanin. The man recovered without complications and went home 4 days after surgery. The article did not report whether this patient had been exposed to asbestos. The author concluded this was the first reported case in which malignant mesothelioma showed up as bowel perforation before the main diagnosis was made.

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 of a single patient
• Who was studied: One 65-year-old man seen in an emergency department. The author is from King Saud University, Riyadh, Saudi Arabia. The date of the case is not stated.
• Exposure: The article reports no asbestos exposure history for this patient. The only exposure mentioned is smoking: the patient was a heavy smoker for 40 years. The discussion notes in general terms that mesothelioma is associated with asbestos exposure.
• Main results:
  • The chest x-ray showed a peripheral mass in the right upper lobe of the lung measuring 5×7 cm2.
  • The CT scan of the chest showed a smooth rounded mass measuring 4.8×8 cm arising from the right chest wall.
  • At exploratory laparotomy, four masses were found on the jejunum, plus another perforated mass 50 cm from the duodenojejunal junction.
  • Sixty centimetres of small bowel were removed and the cut ends were joined.
  • Examination of the removed bowel showed multiple nodules in the bowel wall arising from a highly malignant epithelioid tumor.
  • The tumor cells stained positive for calretinin and podoplanin (D2-40).
  • The patient recovered without complications and was discharged 4 days after surgery.
• The authors' conclusion: The author concluded that this was a rare presentation of a rare disease. The author called it the first reported case in which malignant mesothelioma appeared as bowel perforation before the primary diagnosis.

Topics

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

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

Related studies

• Jejunal Perforation by Metastasis of Malignant Pleural Mesothelioma — M.I. Navarro García, A. Sánchez Pérez, et al. (2015)
• Malignant pleural mesothelioma presenting as an acute surgical abdomen due to metastatic jejunal perforation — K. Gocho, K. Isobe, et al. (2010)
• Solitary malignant mesothelioma of the small intestine: radiological appearances — N. Gourtsoyiannis, D. Bays, et al. (1996)
• Acute abdomen in an asbestos factory worker — S. Narasimhan, D. Brian, et al. (2008)
• An unusual presentation of acute abdomen: infarcted peritoneal cyst-a probable asbestos-related benign cystic mesothelioma — V. Muralidhar (2021)
• A Case Report of Peritoneal Mesothelioma as an Acute Abdomen Mimic: A Rare Presentation and Diagnostic Challenges — L. Fadl, M. Fadl, et al. (2024)

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