Acne inversa complicated by squamous cell carcinoma in association with diffuse malignant peritoneal mesothelioma arising in the absence of predisposing factors: a case report

Our plain-English summary of Acne inversa complicated by squamous cell carcinoma in association with diffuse malignant peritoneal mesothelioma arising in the absence of predisposing factors: a case report, by V. Barresi, E. Vitarelli, G. Barresi (Journal of Cutaneous Pathology, 2008).

The study

• Authors: V. Barresi, E. Vitarelli, G. Barresi
• Journal: Journal of Cutaneous Pathology
• Published: 2008;35(1):70-3
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Diffuse malignant peritoneal mesothelioma (DMPM) is a relatively rare neoplasm. Risk factors associated with its development include asbestos exposure, chronic irritation or inflammation of the peritoneum, abdominal radiotherapy, familial Mediterranean fever and simian virus 40. A familial segregation of this neoplasia has been reported in small villages of the Cappadocian region of Turkey, and it has been postulated that hereditary factors may predispose to mesothelioma, even with exposure to small amounts of asbestos. We report a case of DMPM, which apparently occurred in the absence of predisposing factors in a patient with a clinical history characterized by recurrent pre-sacral acne inversa of long duration. The association of this chronic inflammatory disease with DMPM has never been reported. The genetic locus for acne inversa has recently been identified within the 1p21.1-1q25.3 chromosomal region. Interestingly, frequent losses in chromosomal region 1p.21-22 have been found in mesothelioma as well. It is thus tempting to speculate that genetic mutations involving chromosome 1p.21-22 may account for the development of both diseases.

In plain English

This article was a case report describing one patient. A 47-year-old man, a hospital physician, was admitted with ascites (fluid in the abdomen) and abdominal pain. Tests on the abdominal fluid and a peritoneal biopsy led to a diagnosis of tubulopapillary diffuse malignant peritoneal mesothelioma. He died 3 months after diagnosis. His history recorded no exposure to asbestos and no chronic irritation or irradiation of the peritoneum. None of his family members had been exposed to asbestos. He had had recurrent acne inversa (also called hidradenitis suppurativa), a chronic inflammatory skin disease, in the peri-anal skin for more than 25 years. A squamous cell carcinoma arising in it had been removed surgically one year before the mesothelioma appeared. His sister's 20-year-old son also had acne inversa. The authors described this as the first reported case of an association between acne inversa and peritoneal mesothelioma. They speculated that genetic changes on chromosome 1p21–22 might account for both diseases. They concluded that further epidemiologic studies were needed to determine whether the association was coincidental or causally linked.

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 47-year-old man, a physician employed in a hospital, admitted to the authors' hospital (University of Messina, Italy) with ascites and abdominal pain
• Exposure: No asbestos exposure was found in the patient's history, and none of his family members had been exposed to asbestos. There was no chronic irritation or irradiation of the peritoneum. The patient had recurrent acne inversa of more than 25 years' duration.
• Main results:
  • The peritoneal tumor cells stained strongly for calretinin, EMA and cytokeratins 5/6 and did not stain for CEA. The tumor was classified as a tubulopapillary diffuse malignant peritoneal mesothelioma.
  • The patient died 3 months after the mesothelioma was diagnosed
  • One year before the mesothelioma appeared, the patient had surgery for a squamous cell carcinoma complicating his acne inversa. It was diagnosed as a well-differentiated, infiltrative squamous cell carcinoma.
  • The 20-year-old son of the patient's sister also had acne inversa
• The authors' conclusion: The authors speculated that genetic alterations in the 1p21–22 chromosomal region might account for both the acne inversa and the peritoneal mesothelioma in this patient. They stated that further epidemiologic studies are needed to determine whether the association is coincidental or causally linked.
• Limitations the authors state:
  • This is the only reported case of the association, so it cannot show whether the link is coincidental or causal

Topics

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

Medical terms in this study, explained in our Lexicon: Squamous Cell Carcinoma, Peritoneal Mesothelioma, Neoplasm, Asbestos Exposure, Inflammation, Peritoneum, Mesothelioma.

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