A case of localized peritoneal malignant mesothelioma with ovarian metastasis and literature review

Our plain-English summary of A case of localized peritoneal malignant mesothelioma with ovarian metastasis and literature review, by J. Wang, R. Hu, Q. He (La Medicina del Lavoro, 2022).

The study

• Authors: J. Wang, R. Hu, Q. He
• Journal: La Medicina del Lavoro
• Published: 2022;113(4):e2022035
• Type of article: Case report, Review
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Peritoneal malignant mesothelioma (PMM) is a rare mesothelial cell-derived malignant tumor, which is clinically distinguished into a localized and diffuse forms, the latter being more common. The onset of PMM is insidious, so it is not easy to make a preoperative diagnosis of PMM. Clinicians must pay more attention to this disease in view of its poor prognosis. In order to improve the understanding of PMM, a case of patient with localized PMM metastasizing to the ovary is reported and discussed, along with a review of relevant literature to further explore the etiology, epidemiology, clinical manifestations, examination methods, diagnosis, treatment and prognosis of PMM.

In plain English

This article was a case report followed by a review of published literature on peritoneal malignant mesothelioma. The patient was a 35-year-old woman admitted to the authors' hospital in September 2020 after more than half a year of intermittent upper abdominal pain. She worked as an office clerk and, according to the authors, was not occupationally exposed to asbestos. Her home was near a chemical fiber factory, but any environmental exposure remained unidentified. Her tumor markers were within reference values. During laparoscopy, doctors saw a tumor about 3 cm by 2 cm on the omentum and two masses about 1.5 cm across on the right ovary. The omental tumor and the right ovarian mass were removed. Pathology showed that the abdominal tumor and a right ovarian lesion were localized malignant mesothelioma of the epithelial type, and the ovarian lesion was judged to be a metastasis from the peritoneal mesothelioma. She received three courses of cisplatin intraperitoneal hyperthermic perfusion chemotherapy. She was alive at the time of writing, with no obvious recurrence on imaging. The authors concluded that mesothelioma should be considered in women with abdominal pain.

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 literature review
• Who was studied: One 35-year-old woman with intermittent right upper abdominal pain, admitted to the authors' hospital (Department of Gynecology, Third Affiliated Hospital of Naval Medical University, Shanghai, China) on September 17, 2020
• Exposure: No occupational exposure to asbestos; she worked as an ordinary office clerk
• Main results:
  • The patient's home was near a chemical fiber factory, but any possible environmental exposure remained unidentified
  • Routine blood tests and all tumor markers were within reference values
  • At surgery, a tumor about 3 cm by 2 cm was found on the greater omentum near the hepatic flexure of the colon
  • Two dark red masses about 1.5 cm in diameter were seen on the right ovary; one was partially ruptured
  • Pathology showed the abdominal tumor and the right ovarian lesion were localized malignant mesothelioma of the epithelial type
  • The ovarian lesion was attributed to metastasis of the peritoneal mesothelioma
  • A FISH test found no deletion of the P16 gene in this case
  • The patient received three courses of cisplatin intraperitoneal hyperthermic perfusion chemotherapy
  • At the time of writing, the patient was alive, her tumor markers were normal and imaging showed no obvious recurrence or metastasis
• The authors' conclusion: The authors concluded that mesothelioma is hard to diagnose before surgery. They wrote that its possibility should be considered alongside common diseases in female patients with abdominal pain.
• Limitations the authors state:
  • The authors stated that examination of exfoliated cells in the ascites and immunohistochemical testing were not performed, due to lack of relevant knowledge
  • The authors stated that routine rapid frozen section could not fully show the disease's features, which missed the best time for initial complete removal of the tumor

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Metastasis, Mesothelial Cells, Prognosis, Etiology, Epidemiology.

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• Quality of life of patients with end-stage peritoneal metastasis treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) — K. Odendahl, W. Solass, et al. (2015)
• Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for limited peritoneal metastasis. The PSOGI international collaborative registry — A. Arjona-Sanchez, O. Aziz, et al. (2021)
• A comparative immunohistochemical study of peritoneal and ovarian serous tumors, and mesotheliomas — N. Khoury, U. Raju, et al. (1990)
• PAX8 Expression in a Subset of Malignant Peritoneal Mesotheliomas and Benign Mesothelium has Diagnostic Implications in the Differential Diagnosis of Ovarian Serous Carcinoma — D.B. Chapel, A.N. Husain, et al. (2017)
• p16/CDKN2A FISH in Differentiation of Diffuse Malignant Peritoneal Mesothelioma From Mesothelial Hyperplasia and Epithelial Ovarian Cancer — T. Ito, M. Hamasaki, et al. (2015)
• The diagnostic and molecular characteristics of malignant mesothelioma and ovarian/peritoneal serous carcinoma — B. Davidson (2011)

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