18F-FDG Uptake of Localized Malignant Peritoneal Mesothelioma

Our plain-English summary of 18F-FDG Uptake of Localized Malignant Peritoneal Mesothelioma, by E. Kodama, T. Kodama, T. Ichikawa, et al (Clinical Nuclear Medicine, 2020).

The study

• Authors: E. Kodama, T. Kodama, T. Ichikawa, H. Ikoma, J. Hashimoto
• Journal: Clinical Nuclear Medicine
• Published: 2020;45(2):161-163
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We present 2 cases of malignant peritoneal mesothelioma (MPM) characterized by a localized solid mass without ascites and showing F-FDG uptake. A 79-year-old man with a history of asbestos exposure suffered from an epithelioid MPM originating from the hepatoduodenal ligament with FDG uptake (SUVmax 16.8). Another 80-year-old man with esophageal cancer showed desmoplastic MPM of the small bowel mesentery with FDG uptake (SUVmax 4.0). Desmoplastic MPM is more aggressive and yields poorer prognosis compared with the epithelioid type. However, the present desmoplastic MPM case showed mild FDG uptake because of rich fibrosis.

In plain English

This short image report described two men with malignant peritoneal mesothelioma, a cancer of the abdominal lining, that formed a localized solid mass. Both had 18F-FDG PET/CT scans, which show how much of a sugar-like tracer tissue takes up (measured as SUVmax). The first, aged 79 with a history of asbestos exposure, had a mass in the hepatoduodenal ligament near the liver that showed markedly increased uptake (SUVmax 16.8). After surgery it was diagnosed as epithelioid mesothelioma. The second, aged 80 with esophageal cancer, had a mass in the small bowel mesentery with slightly increased uptake (SUVmax 4.0). It was diagnosed as desmoplastic mesothelioma, a rare subtype of sarcomatoid mesothelioma. The authors linked the high uptake to high cellularity and the low uptake to rich fibrosis. The article gave no details of the first patient's exposure and did not say whether the second was exposed. From what they called limited data, the authors concluded that FDG uptake of localized peritoneal mesothelioma varies and is independent of the pathological findings or malignant potential.

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 2 patients (journal section 'Interesting Image')
• Who was studied: Two men with localized malignant peritoneal mesothelioma. The first was 79 years old and had had early gastric cancer removed endoscopically 4 years earlier. The second was 80 years old and had esophageal cancer. The authors were at Tokai University School of Medicine, Isehara, Japan. The article gives no dates of care.
• Exposure: The first patient had a history of asbestos exposure. The article gives no fiber type, job or dose, and does not state the second patient's asbestos history. The study's focus was 18F-FDG PET/CT imaging.
• Main results:
  • First patient: the mass in the hepatoduodenal ligament showed markedly increased FDG uptake, with an SUVmax of 16.8.
  • First patient: after tumor resection, the histopathologic diagnosis was epithelioid MPM.
  • Second patient: the small bowel mesenteric mass showed slightly increased FDG uptake, with an SUVmax of 4.0. The diagnosis was desmoplastic MPM. The patient's esophageal lesion had an SUVmax of 14.1.
  • The authors attributed the high uptake in the epithelioid case to high cellularity, and the low uptake in the desmoplastic case to rich fibrosis.
  • The authors stated that the second patient seems to be the first reported case of desmoplastic MPM evaluated using 18F-FDG PET/CT.
• The authors' conclusion: The authors concluded, from limited data, that FDG uptake of localized MPM varies and is independent of the pathological findings or malignant potential.
• Limitations the authors state:
  • The authors described their data (two cases) as limited.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Ascites, Asbestos Exposure, Epithelioid, Esophageal Cancer, Desmoplastic Mesothelioma, Small Bowel Mesentery, Prognosis.

Related studies

• A Case of Localized Malignant Peritoneal Mesothelioma With Lung Cancer Detected by 18F-FDG PET/CT — S. Kobayashi Shimizu, T. Okamura, et al. (2020)
• The role of 18F-FDG-PET/ceCT in peritoneal mesothelioma — J. Dubreuil, F. Giammarile, et al. (2017)
• 18F-FDG-PET/CT of peritoneal tumors: a pictorial essay — J. Dubreuil, F. Giammarile, et al. (2017)
• Focal Peritoneal Mesothelioma Demonstrated on FDG PET/CT — J. Xiao, H. Yin, et al. (2019)
• Whole-Body MRI: Comparison of Its Capability for TNM Staging of Malignant Pleural Mesothelioma With That of Coregistered PET/MRI, Integrated FDG PET/CT, and Conventional Imaging — Y. Ohno, M. Yui, et al. (2019)
• Prognostic value of pretreatment volume-based quantitative 18F-FDG PET/CT parameters in patients with malignant pleural mesothelioma — K. Kitajima, H. Doi, et al. (2017)

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