Solitary cerebellar metastasis of malignant pleural mesothelioma: case report

Our plain-English summary of Solitary cerebellar metastasis of malignant pleural mesothelioma: case report, by C.J. Winfree, W.J. Mack, M.B. Sisti (Surgical Neurology, 2004).

The study

• Authors: C.J. Winfree, W.J. Mack, M.B. Sisti
• Journal: Surgical Neurology
• Published: 2004;61(2):174-8; discussion 178-9
• Type of article: Case report, Review
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Malignant pleural mesothelioma is an uncommon malignancy that rarely metastasizes to the central nervous system and even less frequently occurs as a solitary lesion.

Case Description: We present a 71-year-old white female, nonsmoker, with no occupational exposure to asbestos. She presented with a 15-lb. weight loss over several months and persistent right subscapular pain radiating to her anterior chest. Imaging studies revealed a pleural mass, and biopsy confirmed fibrous type malignant pleural mesothelioma. During a metastatic workup, computed tomography (CT) and magnetic resonance imaging (MRI) of the head demonstrated a 1 cm subcortical, contrast-enhancing lesion without surrounding edema in the right posterior cerebellum. Surgical resection of the solitary cerebellar mass revealed fibrous-type metastatic malignant mesothelioma. Postoperatively, the patient received a combined chemotherapy regimen of Adriamycin and Cisplatin and underwent whole brain radiation therapy.

Conclusions: We report the first resection of a solitary cerebellar metastasis of malignant pleural mesothelioma. We also review past cases of intracranial metastasis of this malignancy, its histologic subtypes, outcome, and recent treatment modalities.

In plain English

This case report described one patient and included a table of earlier published reports of brain metastases from mesothelioma. The patient was a 71-year-old white female nonsmoker with no occupational exposure to asbestos. The authors noted that her father had worked at a shipyard. The article calls him a shipbuilder in one place and a pipefitter in another. She came to medical attention after a 15-lb. weight loss. Biopsies taken during chest surgery were consistent with fibrous malignant pleural mesothelioma. When doctors checked whether the cancer had spread, head scans found a 1 cm lesion in the right back part of the cerebellum, although she had no neurologic symptoms. Surgeons removed it, and it proved to be metastatic fibrous malignant pleural mesothelioma. She then received chemotherapy with Adriamycin and Cisplatin and whole brain radiation. She died of cardiopulmonary arrest caused by disease in the chest, 8 months after her first symptoms. The authors concluded that theirs was the first surgical removal of a solitary cerebellar metastasis from malignant pleural mesothelioma. A single case report describes one patient and does not give a rate.

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 one patient, with a review of previously published reports of brain metastases from malignant mesothelioma
• Who was studied: one 71-year-old white female nonsmoker with no occupational asbestos exposure, treated at Columbia University, New York
• Exposure: no occupational asbestos exposure; her father worked at a shipyard, described as a shipbuilder at a local dockyard in the case report and as a pipefitter at a shipyard in the discussion. No fiber type or dose was reported for this patient
• Main results:
  • The patient first presented after a 15-lb. weight loss
  • Biopsies from masses in the right upper lobe, chest wall and pleura were consistent with fibrous malignant pleural mesothelioma
  • Head CT and MRI showed a 1 cm subcortical, contrast-enhancing lesion in the right posterior cerebellum; the patient had no neurologic symptoms and a normal neurologic examination
  • The surgically removed cerebellar lesion proved to be metastatic fibrous malignant pleural mesothelioma
  • After surgery she received Adriamycin and Cisplatin chemotherapy and whole brain radiation therapy
  • She died of cardiopulmonary arrest secondary to intrathoracic disease 8 months after the onset of her initial symptoms
• The authors' conclusion: The authors concluded that their case was the first surgical resection of a solitary cerebellar metastasis from malignant pleural mesothelioma

Topics

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

Medical terms in this study, explained in our Lexicon: Metastasis, Pleural Mesothelioma, Occupational Exposure, Biopsy, Surgical Resection, Mesothelioma, Chemotherapy, Cisplatin.

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