Solitary Mesothelioma of the Small Intestine

Our plain-English summary of Solitary Mesothelioma of the Small Intestine, by D.G. Lichtenstein, A. Iellin, M.M. Lowenthal, et al (1975).

The study

• Authors: D.G. Lichtenstein, A. Iellin, M.M. Lowenthal, B. Morag
• Published: International Surgery, Volume 60 No6&7, June-July 1975
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was a case report about one patient: a 52-year-old man treated at a medical center in Tel Aviv, Israel. He came to the emergency ward with four days of abdominal pain that had settled in the lower right abdomen, and he was operated on for suspected acute appendicitis. The appendix looked normal. Instead, surgeons found a hard mass in the ileum (the last part of the small intestine), growing within its outer layer, and removed it with a right hemicolectomy. Under the microscope the tumor was a mesothelioma of the sarcomatous type. It had grown into the muscle layer of the bowel, and it was considered a low grade malignant tumor. The authors attributed his appendicitis-like symptoms to bleeding into the bowel's outer layer. One year after the operation he was in good health with no evidence of malignancy. The report did not describe any asbestos exposure for this patient. The authors concluded that this appeared to be the first report of successful removal of a malignant mesothelioma of the terminal ileum.

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 earlier published literature
• Who was studied: One 52-year-old man admitted to the emergency ward of a municipal government medical center in Tel Aviv, Israel; his past history included bronchial asthma. The date of the case is not given beyond the article being accepted in 1974.
• Exposure: The article does not report any asbestos exposure, occupation, or fiber type for this patient. The link between mesothelioma and asbestos appears only in the discussion, which cites studies by others.
• Main results:
  • At operation the appendix seemed normal. A hard mass was found in the ileum, 14 cm from the junction with the large bowel, on the antimesenteric surface within the serosa (outer layer). It was covered by fibrin and pus, and no regional lymph nodes were noted.
  • Because malignancy was suspected, a right hemicolectomy was performed; the postoperative period was uneventful and the patient was discharged on the 12th postoperative day.
  • The tumor was a mesothelioma of the sarcomatous type, with spindle cells, multinucleated giant cells and occasional mitosis. It penetrated into the muscle layer, the mucosa was free, and it was considered a low grade malignant tumor.
  • The authors stated that the clinical picture of acute appendicitis in this patient was due to hemorrhage in the serosa causing regional peritonitis, and that no weight loss, abdominal pain or cramps came before the sudden attack.
  • One year after the operation the patient was in good health with no evidence of malignancy.
• The authors' conclusion: The authors concluded that the case appeared to be the first report of successful resection of a malignant mesothelioma of the terminal ileum, with the patient apparently in good health and cancer free one year later.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure.

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