Peritoneal Malignant Psammomatous Mesothelioma

Our plain-English summary of Peritoneal Malignant Psammomatous Mesothelioma, by T. Pusiol, M.G. Zorzi, D. Morichetti, et al (World Journal of Oncology, 2010).

The study

• Authors: T. Pusiol, M.G. Zorzi, D. Morichetti, I. Piscioli, M. Scialpi
• Journal: World Journal of Oncology
• Published: 2010;1(4):179-181
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Psammoma bodies (PBs) are observed most commonly in papillary thyroid carcinoma, meningioma, and papillary serous cystadenocarcinoma of the ovary. We report one case of peritoneal malignant mesothelioma (PMM) with massive deposition of PBs. A 72-years-old man presented with abdominal swelling and marked weight loss. Contrast enhanced computed tomography showed fluid diffuse in peritoneal recesses, thick septa with micronodules in the greater omentum and adjacent enhancement of the thickened peritoneum. The explorative laparoscopy showed diffuse minute parietal peritoneal nodules. The peritoneal biopsy revealed a superficial papillary growth of malignant epithelial-like cells with diffuse involvement of submesothelial tissues. Massive deposition of PBs was observed. Nuclear and cytoplasmic calretinin immunoreactivity was present in neoplastic cells along with membranous D2-40 and membranous/cytoplasmic cytokeratin 5 staining. The patient was treated with chemotherapy (gemcitabine, vinorelbine, cisplatin). PBs may represent an active biologic process ultimately leading to degeneration/death of tumor cells and retardation of growth of the neoplasm. It may also serve as a barrier against the spread of tumor. Psammomatous malignant mesothelioma may simulate serous psammocarcinoma of the peritoneum. The behavior of serous psammocarcinoma is more closely similar to borderline serous tumor than to serous carcinoma. Further studies are necessary to establish if massive deposition of PBs may define a new variant of psammomatous malignant mesothelioma with a favorable impact to the prognosis of usual psammomatous malignant mesothelioma, as well as in serous psammocarcinoma of the peritoneum.

In plain English

This article was a case report describing one 72-year-old man with peritoneal malignant mesothelioma, a cancer of the lining of the abdomen. The patient came to doctors with abdominal swelling and marked weight loss. The authors reported that no history of exposure to asbestos was found. A CT scan showed fluid in the abdomen, a thickened abdominal lining, and small nodules in the fatty tissue of the abdomen. Malignant cells were found in the abdominal fluid, and a keyhole examination showed many tiny nodules on the abdominal lining. The biopsy showed cancer cells with a massive deposit of psammoma bodies, which are small layered calcium spheres. Stains for calretinin, D2-40 and cytokeratin 5 were positive. The authors said this confirmed mesothelioma and ruled out serous psammocarcinoma, a tumor it can resemble. The patient received chemotherapy with gemcitabine, vinorelbine and cisplatin. The article did not report how the patient fared afterward. The authors stated that massive deposits of this kind had not been reported before in this cancer. They suggested the deposits might slow the tumor's growth and spread. They concluded that further studies were needed to see whether such deposits define a new variant with a better outlook.

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 (one patient)
• Who was studied: one 72-year-old man with abdominal swelling and marked weight loss
• Exposure: No history of asbestos exposure was found; no fiber type is named.
• Main results:
  • CT scan showed thick septa with micronodules in the greater omentum, along with fluid in the peritoneal recesses and a thickened peritoneum.
  • Malignant cells were found in the patient's ascites (abdominal fluid).
  • Laparoscopy showed diffuse minute nodules on the parietal peritoneum.
  • The peritoneal biopsy showed massive deposition of psammoma bodies.
  • The tumor cells were positive for calretinin, CK5 and D2-40. The authors said this profile was conclusive of mesothelioma and excluded serous psammocarcinoma of the peritoneum.
  • The patient was treated with chemotherapy (gemcitabine, vinorelbine, cisplatin); no outcome is reported.
  • The authors stated that massive psammoma body deposits had not previously been reported in peritoneal malignant mesothelioma.
• The authors' conclusion: The authors suggested that psammoma bodies may reflect a process that slows tumor growth and spread. They concluded that further studies are needed to establish whether massive deposits define a new variant of peritoneal malignant mesothelioma with a more favorable prognosis.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Carcinoma, Deposition, Omentum, Peritoneum, Biopsy, Calretinin, Podoplanin (D2-40).

Related studies

• Diffuse Malignant Peritoneal Mesothelioma Presenting with Psammomatous Calcification on a Cervical Smear — A. Tan, P. Cohen, et al. (2015)
• Peritoneal mesothelioma — M. Kannerstein, J. Churg (1977)
• Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients — E.A. Levine, J.H. Stewart, et al. (2014)
• Epidemiology of peritoneal mesothelioma: a review — P. Boffetta (2007)
• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: a systematic review and meta-analysis — J.H. Helm, J.T. Miura, et al. (2015)
• Absence of carcinogenic response to multiwall carbon nanotubes in a 2-year bioassay in the peritoneal cavity of the rat — J. Muller, M. Delos, et al. (2009)

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