Peritoneal mesothelioma in a woman who has survived for seven years: a case report

Our plain-English summary of Peritoneal mesothelioma in a woman who has survived for seven years: a case report, by K. Pillai, J. Akhter, M.H. Pourgholami, et al (Journal of Medical Case Reports, 2011).

The study

• Authors: K. Pillai, J. Akhter, M.H. Pourgholami, D.L. Morris
• Journal: Journal of Medical Case Reports
• Published: 2011;5:36
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Malignant peritoneal mesothelioma is a rare cancer with poor patient survival. Female gender has been identified as a positive prognostic factor. Recently, it has been suggested that the expression of estrogen receptor β in malignant mesothelioma leads to tumor suppression and a better prognosis.

Case Presentation: We report the case of a 48-year-old Caucasian woman who is alive and disease-free seven years after the initial diagnosis and treatment of malignant peritoneal mesothelioma.

Conclusion: This patient's long survival may be attributable to a combination of factors, including minimal disease, complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy plus the estrogen receptor β positivity of the tumor.

In plain English

This was a case report describing one woman with malignant peritoneal mesothelioma, a cancer of the lining of the abdomen. She presented at age 40 with abdominal pain, a bad taste in her mouth and tiredness, after four to five years of upper abdominal discomfort, and was 48 when the report was written. A biopsy showed malignant mesothelioma of epithelial type. The patient denied any exposure to asbestos. Scans and surgical scoring showed a low volume of disease. She had surgery to remove the tumor followed by heated chemotherapy placed directly into the abdomen (HIPEC), and she refused further chemotherapy after surgery. Two years later a second operation found very low-volume disease, and she received a second round of HIPEC. After that, scans and tissue tests showed no malignancy. Her tumor tissue stained heavily for estrogen receptor beta. The authors reported she was alive and well past seven years. The authors concluded her long survival may be attributable to a combination of minimal disease, complete surgery with HIPEC, and the estrogen receptor beta positivity of the tumor.

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 Caucasian woman who presented at age 40 and was aged 48 at the time of the report; the authors are from the Department of Surgery, St. George Hospital, University of New South Wales, Australia
• Exposure: The patient denied any asbestos exposure. The report describes her treatment: surgery to remove the tumor (cytoreduction) and heated intraperitoneal chemotherapy (HIPEC) with cisplatin, Adriamycin and paclitaxel, and later a second HIPEC with cisplatin and mitomycin C.
• Main results:
  • Before she presented, she had had upper abdominal (epigastric) discomfort from abdominal distension for four to five years and had undergone multiple gastrointestinal endoscopic examinations.
  • A biopsy showed malignant mesothelioma of epithelial type.
  • Disease volume measured by the peritoneal cancer index was low.
  • At the first operation, HIPEC was given with cisplatin, Adriamycin and paclitaxel.
  • At a second operation two years later, the authors concluded that very low-volume disease was present and that her pain was mainly due to adhesions.
  • The patient refused postoperative chemotherapy.
  • After the second HIPEC, CT scans and immunohistochemical tests showed no malignancy.
  • The patient's tumor tissue stained heavily for estrogen receptor beta.
  • The patient was alive and well past seven years.
• The authors' conclusion: The authors concluded the patient's long survival may be attributable to a combination of factors: minimal disease, complete cytoreductive surgery with HIPEC, and the estrogen receptor beta positivity of the tumor. In the discussion they also pointed to the epithelioid tumor type and a high plasma estradiol level.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelioma, Prognosis, Cytoreductive Surgery, HIPEC.

Related studies

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• Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman — B. Pang, C. Hu, et al. (2021)
• A 51-Year-Old Woman with Advanced Peritoneal Mesothelioma and Stage 3b Chronic Kidney Disease Treated with Cytoreductive Surgery and Bidirectional Intraperitoneal Cisplatin and Ifosfamide Chemotherapy: A Case Report — M. Alaswad, F. ElKordy, et al. (2023)
• A seven-year disease-free survivor of malignant pleural mesothelioma treated with hyperthermia and chemotherapy: a case report — N. Okonogi, T. Ebara, et al. (2012)
• p53 Expression in a Malignant Mesothelioma Patient during Seven-Year Follow-up — S.M. Koo, S.T. Uh, et al. (2014)
• Well-Differentiated Papillary Mesothelioma With Two Synchronous Serous Gynaecologic Carcinomas in a 62-Year-Old Woman: Lessons Learned for the Gynaecologic Surgeon — J.M. McGinnis, V. Bloomfield, et al. (2020)

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