Prostate Carcinoma and Pleural Mesothelioma: An Extremely Rare Co-occurrence

Our plain-English summary of Prostate Carcinoma and Pleural Mesothelioma: An Extremely Rare Co-occurrence, by T.P. Soni, S. Soni, N. Somani, et al (Curēus, 2019).

The study

• Authors: T.P. Soni, S. Soni, N. Somani, T. Bhattacharya, N. Kucha
• Journal: Curēus
• Published: 2019;11(5):e4655
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural mesothelioma and carcinoma prostate as metachronous double malignancy is extremely rare co-occurrence. A 67-year-old male, diagnosed case of carcinoma prostate with bone metastasis, was treated with chemotherapy and hormone therapy. He responded well to chemotherapy and hormone therapy. He remained asymptomatic for two years with serum prostate-specific antigen (PSA) values within normal limits. After two years of diagnosis of carcinoma prostate, he developed left lung pleural sarcomatoid mesothelioma as a second metachronous tumor. Malignant pleural mesothelioma as a metachronous second tumor in a case of carcinoma prostate is rarely reported in the literature. The long-life expectancy, old age, late effects of the treatment, genetic predisposition and lifestyle factors of patients with carcinoma prostate expose them to the possibility of developing second primary tumor.

In plain English

This was a case report of one man. A 67-year-old man, described as a retired security officer of a copper mines area, had prostate adenocarcinoma (Gleason score 3 + 4 = 7) that had spread to the right iliac (hip) bone, with a PSA blood level of 67.69 ng/ml. After docetaxel chemotherapy and hormone therapy, his PSA fell to 0.016 ng/ml after three months, and he stayed symptom-free for two years. He then developed breathlessness and left chest pain. A CT scan showed fluid around the left lung, pleural thickening with calcification, and a 17 x 13 mm nodule. A biopsy showed sarcomatoid mesothelioma of the pleura, the lining around the lung, as a second, separate cancer. After six cycles of pemetrexed and carboplatin, disease remained and palliative care was advised. The article did not report any asbestos exposure for this man. The figures in the discussion came from other studies, not this case. The authors concluded that mesothelioma as a second cancer after prostate cancer is extremely rare and that further research is warranted.

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 discussion of published literature
• Who was studied: One 67-year-old man, a retired security officer of a copper mines area, first seen with urinary difficulty and backache. The authors are based at hospitals in Jaipur and Jodhpur, India. No dates of care are given.
• Exposure: The article does not report any asbestos exposure or fiber type for this patient. It gives only his former job, security officer of a copper mines area.
• Main results:
  • The prostate biopsy showed moderately differentiated adenocarcinoma, Gleason score 3 + 4 = 7. Serum PSA was 67.69 ng/ml, and there was a right iliac bone metastasis.
  • After docetaxel chemotherapy with denosumab, bicalutamide and goserelin, serum PSA fell to 0.016 ng/ml after three months. He remained without symptoms for two years on hormone therapy.
  • Two years after the prostate cancer diagnosis, a CT scan showed a left pleural effusion, left pleural thickening with calcification, and a 17 x 13 mm pleural-based nodule. Pleural fluid cytology showed no malignant cells.
  • A biopsy of the left pleural nodule, with immunohistochemistry, was suggestive of sarcomatoid mesothelioma with chondrosarcomatous differentiation. The Ki67 proliferation index was 80%, and staining was negative for PSA and NKX3.1.
  • After six cycles of pemetrexed and carboplatin chemotherapy, PET-CT showed residual disease in the left lung and pleura. Best supportive management with palliative care was advised.
• The authors' conclusion: The authors concluded that mesothelioma as a second cancer in patients with prostate carcinoma is extremely rare, and that further research is warranted to establish whether the two are associated.

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Pleural Mesothelioma, Metastasis, Chemotherapy, Sarcomatoid, Mesothelioma, Life Expectancy.

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