Ocular melanoma in a patient successfully treated for diffuse malignant peritoneal mesothelioma: a case report

Our plain-English summary of Ocular melanoma in a patient successfully treated for diffuse malignant peritoneal mesothelioma: a case report, by S. Langlais, J.P. Velazquez-Martin, P. Dubé, et al (World Journal of Surgical Oncology, 2012).

The study

• Authors: S. Langlais, J.P. Velazquez-Martin, P. Dubé, E.R. Simpson, G. Leblanc, L. Sideris
• Journal: World Journal of Surgical Oncology
• Published: 2012;10:90
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Diffuse malignant peritoneal mesothelioma and ocular melanoma are both rare tumors. To the best of our knowledge there is only one previous report of three cases in a family with known susceptibility to malignancies associating diffuse malignant peritoneal mesothelioma and ocular melanoma, with no sporadic cases previously reported.

Case Presentation: We describe the case of a 59-year-old man with a history of diffuse malignant peritoneal mesothelioma, who presented with ocular melanoma 41 months after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. We also briefly review the literature.

Conclusions: Diffuse malignant peritoneal mesothelioma is an uncommon but aggressive disease. As diffuse malignant peritoneal mesothelioma characteristically remains confined to the abdominal cavity, any new extra-abdominal symptom should eventually raise suspicion of another primary tumor. Few cases of diffuse malignant peritoneal mesothelioma associated with other primary tumors have been reported. As ocular melanoma is also infrequent, we suspect a genetic predisposition to these tumors. There is emerging evidence supporting the role of BAP1 mutations in the pathogenesis of these two neoplasias.

In plain English

This article was a case report about one patient. A 59-year-old man sought medical care in 2005 for abdominal discomfort, nausea and belching. He had no family history of cancer and no history of asbestos exposure. Tests confirmed diffuse malignant peritoneal mesothelioma of the epithelial subtype. The authors' team performed complete cytoreductive surgery with heated chemotherapy delivered inside the abdomen (HIPEC), leaving no residual tumor. A scan 36 months after treatment showed no recurrence. At 41 months he developed blurred vision from a pigmented mass in his left eye. Doctors first assumed it was spread of the mesothelioma and gave external radiation, but the mass grew. Specialist eye-cancer doctors then diagnosed ocular melanoma and treated it with an iodine-125 radioactive plaque. By October 2011 the tumor had shrunk to 2.9 mm in height, and scans showed no sign of either cancer returning. The authors described this as the first known case of both cancers in one person with no family history. They suggested it was probably a BAP1-related cancer syndrome. BAP1 genetic testing of the patient and his family was still in progress.

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 59-year-old man first seen in 2005, treated at the authors' institution (Department of Surgery, Hôpital Maisonneuve-Rosemont, Montréal, Canada, per the author affiliations)
• Exposure: The patient had no reported history of asbestos exposure and no family history of cancer
• Main results:
  • Pathology and immunohistochemistry confirmed diffuse malignant peritoneal mesothelioma (DMPM) of the epithelial subtype
  • Complete cytoreductive surgery and HIPEC left no residual tumor (completeness of cytoreduction score 0). The peritoneal cancer index was 21 out of a possible 39
  • A PET-CT scan 36 months after treatment (June 2009) showed no evidence of recurrence
  • At 41 months after surgery (November 2009) the patient had blurred vision in the left eye. Examination found a pigmented choroidal mass measuring 6.9 × 9.2 mm in base and 2.5 mm in height
  • The eye tumor was first assumed to be a metastasis of the mesothelioma and treated with 40 Gy external beam radiotherapy. It did not respond and grew to 8.1 × 11.3 mm in base and 2.9 mm in height
  • After evaluation by ocular oncologists, a diagnosis of ocular melanoma was supported, and iodine-125 plaque brachytherapy (80 Gy to the tumor apex) was given in November 2010
  • In October 2011 the eye tumor measured 2.9 mm in height, and PET-CT showed no sign of recurrence of either the mesothelioma or the ocular melanoma
• The authors' conclusion: The authors concluded that this was, to their knowledge, the first known case of DMPM and ocular melanoma in the same individual with no family history. They wrote that it supports a clinical correlation between the two cancers, probably as a BAP1-related cancer syndrome. BAP1 genetic testing of the patient and family was in progress.

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: Peritoneal Mesothelioma, Cytoreductive Surgery, HIPEC, BAP1.

Related studies

• Malignant peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is GLUT1 expression a major prognostic factor? A preliminary study — J. Hommell-Fontaine, S. Isaac, et al. (2013)
• Recurrence of Optimally Treated Malignant Peritoneal Mesothelioma with Cytoreduction and Heated Intraperitoneal Chemotherapy — D.R. Heller, C. Chiuzan, et al. (2017)
• The Role of Ki-67 and Pre-cytoreduction Parameters in Selecting Diffuse Malignant Peritoneal Mesothelioma (DMPM) Patients for Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) — S. Kusamura, P.A. Torres Mesa, et al. (2016)
• Iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent or progressive diffuse malignant peritoneal mesothelioma: clinicopathologic characteristics and survival outcome — C. Ihemelandu, L. Bijelic, et al. (2015)
• Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma — T.C. Chua, T.D. Yan, et al. (2011)
• Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) — D. Baratti, M. Vaira, et al. (2010)

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