A primary mesothelioma involving the rectovaginal septum and associated with beryllium

Our plain-English summary of A primary mesothelioma involving the rectovaginal septum and associated with beryllium, by C. Gold (The Journal of Pathology and Bacteriology, 1967).

The study

• Author: C. Gold
• Journal: The Journal of Pathology and Bacteriology
• Published: 1967;93(2):435-42
• Type of article: Case report
• Cited by: 33 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002737).

Abstract

This paper describes an unusual case with serosal tumour deposits in the peritoneal cavity associated with a tumour, believed to be a mesothelioma, in the rectovaginal septum, and with a history of traumatic vaginal lesions repeatedly exposed by douching to hard water containing soluble beryllium compounds. Environmental contact with asbestos was a complicating factor. Analysis of the tumour tissue confirmed the presence of a significant amount of beryllium, which must be considered as a possible carcinogenic agent.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This was a case report from Glasgow about one woman, aged 34, first seen in 1962. She had a mass in the rectovaginal septum (the tissue between the rectum and vagina) and small tumour deposits on the pelvic peritoneum and ovarian surfaces. From 1951 to 1960 she lived on farms in Southern Rhodesia. From 1952 to 1956 she worked closely with beryllium, lithium and tantalite ores, and she later lived next to an asbestos mine without direct personal contact with asbestos. She also had vaginal injuries in childbirth that were treated by douching with local hard water. The tumour was removed, and she was well over 5 years later. The author regarded it as an extension of a primary peritoneal mesothelioma. No asbestos fibres were found in the tissue. Beryllium was detected in the tumour and in the farm tap water; the scanned text leaves the units of these measurements unclear. The author postulated that beryllium was the likely cause. The author also noted that only a post-mortem examination could settle the diagnosis, and that finding no asbestos did not rule asbestos out.

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)
• Who was studied: One 34-year-old woman seen in Glasgow in 1962, who had lived on farms in Southern Rhodesia (Fort Victoria area) from 1951 to 1960
• Exposure: Close working contact with beryllium, lithium and tantalite ores on her own farm (1952 to 1956). Environmental contact with asbestos from 1956 to 1960, living on a farm bordering an asbestos mine at Mashaba; the asbestos was described only as 'of the small-fibre type' and she had no direct personal contact with it. Repeated vaginal birth trauma treated by douching and baths in hard local water.
• Main results:
  • The tumour was regarded as a direct extension into the rectovaginal septum from a primary peritoneal mesothelioma
  • The patient recovered after surgery and was still well more than 5 years later, with no recurrence or spread reported
  • Incineration of the tumour tissue, with and without acid extraction, found no asbestos fibres
  • Histochemical reactions were considered consistent with mesothelioma
  • Analysis of the tumour tissue found beryllium at an amount printed as 0.04 per gram (unit unclear in the scan), which the analyst called significant
  • A sample of tap water from the first farm, analysed in April 1966, contained beryllium at a concentration printed as 0.035 per litre (unit unclear in the scan), which the author regarded as abnormal
  • The numerous calcified (psammoma) bodies in the tumour were shown to be visible on X-ray of the specimen
• The authors' conclusion: The author concluded that the beryllium found in the tumour must be seriously considered as the likely cause, and postulated that beryllium compounds may in certain circumstances become carcinogenic. The author described the case as the first proven direct association between beryllium and a human tumour. As a separate, self-described speculative idea, the author raised whether beryllium in irrigated tobacco might relate to the carcinogenic effect of cigarette tobacco.
• Limitations the authors state:
  • Only a detailed post-mortem examination could give a conclusive answer on the diagnosis
  • Finding no asbestos does not exclude asbestos exposure as the cause of the mesothelioma
  • Beryllium is difficult to demonstrate histochemically, and permanent preparations could not be obtained
  • A beryllium patch test, which might have helped, was not done because of the risk of worsening any latent lung berylliosis

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneal Cavity, Carcinogenic.

Related studies

• Risk of lung cancer associated with quantitative beryllium exposure metrics within an occupational cohort — M.K. Schubauer-Berigan, J.A. Deddens, et al. (2011)
• Effects of asbestos and beryllium on release of alveolar macrophage enzymes — K.Y. Kang, D. Bice, et al. (1979)
• Beryllium detection in human lung tissue using electron probe X-ray microanalysis — K.J. Butnor, T.A. Sporn, et al. (2003)
• Government laboratory worker with lung cancer: comparing risks from beryllium, asbestos, and tobacco smoke — C. Steinmaus, J.R. Balmes (2000)
• Malignant mesothelioma of the tunica vaginalis. A clinicopathologic analysis of 11 cases with review of the literature — M.A. Jones, R.H. Young, et al. (1995)
• Asbestos exposure and neoplasia — I.J. Selikoff, J. Churg, et al. (1964)

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