An autopsy case of serous papillary carcinoma of peritoneum with distant metastases but no peritoneal dissemination

Our plain-English summary of An autopsy case of serous papillary carcinoma of peritoneum with distant metastases but no peritoneal dissemination, by O. Miyaishi, K. Iida, S. Saga, et al (Gynecologic Oncology, 1994).

The study

• Authors: O. Miyaishi, K. Iida, S. Saga, T. Sato
• Journal: Gynecologic Oncology
• Published: 1994;55(3 Pt 1):448-52
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of a 61-year-old woman who had a serous papillary carcinoma of probable peritoneal or surface ovarian origin, which formed a single tumor mass in the pelvis but did not metastasize throughout the abdominal cavity but only to the pleura and then the hilar lymph nodes over a protracted period lasting more than 7 years, is reported. This unusually behaving tumor was well differentiated and at least partially responded to therapy, as witnessed by its histologic appearance at autopsy. This type of neoplasm usually shows diffuse peritoneal dissemination and no distant metastasis.

In plain English

This case report described a 61-year-old woman with no smoking or occupational history whose chest X-ray showed shadows in March 1983. Tumors removed from her chest wall and diaphragm were suspected to be papillary carcinoma or malignant mesothelioma. A tumor that looked similar under the microscope was then found on the right pelvic wall. She received radiation with hyperthermia and then chemotherapy, and died of respiratory failure in May 1990. At autopsy there was no fluid in the abdomen and the peritoneum was smooth. The pelvic tumor consisted mostly of psammoma bodies and fibrous tissue with very few living cells, and cancer had spread to the right hilar lymph nodes. Staining and electron microscopy pointed to carcinoma rather than mesothelioma. The authors wrote that asbestos fiber analysis of the lungs suggested low exposure. They concluded the tumor was a serous papillary carcinoma of the peritoneum, while noting that an ovarian origin could not be absolutely excluded. They reported the case for the unusual way the cancer spread.

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 autopsy case)
• Who was studied: One 61-year-old woman, followed from abnormal chest X-ray findings in March 1983 until her death on May 3, 1990. The authors were at Aichi Medical University and Nagoya University School of Medicine, Japan.
• Exposure: No smoking or occupational history was reported. Asbestos fibers in lung tissue were measured after death; the fiber type was not specified. The authors said the results suggested low exposure.
• Main results:
  • Tumors excised from the chest wall and diaphragm were suspected under the microscope to be papillary carcinoma or malignant mesothelioma.
  • A biopsy of the pelvic tumor looked very similar under the microscope to the chest specimen.
  • In February 1987 she received radiation therapy (60 Gy) with hyperthermia for genital bleeding, followed by 5-fluorouracil chemotherapy (200 mg/day by mouth for 16 weeks). The genital bleeding stopped completely.
  • Her condition gradually worsened as the tumors in her chest grew, and she died of respiratory failure.
  • At autopsy there was no ascites (abdominal fluid), and the peritoneum was smooth.
  • The 7 cm pelvic tumor consisted of numerous psammoma bodies and a small amount of fibrous tissue, with very few living tumor cells.
  • The cancer had spread to the right hilar lymph nodes.
  • The authors wrote that immunostaining findings, including positive staining for CA125, CA19-9 and sialosyl-Tn, suggested the tumor was a carcinoma. Tumor cells did not stain for CEA.
  • Under electron microscopy, the microvilli on the tumor cells were neither as long nor as numerous as those usually seen in mesothelioma.
  • The authors found no significant accumulation of asbestos fibers in the lungs and took this as further suggesting that mesothelioma was unlikely.
  • The lung samples measured between 0.18 and 3.4 (units partly unreadable in the scan), and the tumor was not analyzed. The mean lung concentration in the control study was 2.28.
  • The authors considered the spread unusual: distant metastases to the chest were seen from early in the disease, yet there was no spread through the peritoneum even at autopsy.
• The authors' conclusion: The authors concluded that the tumor was a serous papillary carcinoma of the peritoneum, probably covering the fallopian tube or broad ligament.
• Limitations the authors state:
  • The authors stated that their findings could not absolutely exclude an ovarian origin for the tumor.

Topics

Medical terms in this study, explained in our Lexicon: Autopsy, Serous Papillary Carcinoma, Peritoneum, Metastasis, Pleura, Hilar Lymph Nodes, Neoplasm.

Related studies

• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Papillary serous carcinoma of the tunica vaginalis testis — P. Becerra, M.A. Isaac, et al. (2000)
• Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary; case report — M. Swerdlow (1959)
• Immunohistochemical profile of paratesticular serous papillary adenocarcinoma and tunica vaginalis facilitates distinction from malignant mesothelioma — P.R. Anchala, R. Dhir, et al. (2011)
• Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases — U. Raju, G. Fine, et al. (1989)
• Peritoneal malignant mesothelioma with multiple distant skin metastases — N.G. Ordóñez, J.L. Smith (1983)

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