An incidental diagnosis of well-differentiated papillary mesothelioma in a woman operated on for recurrent endometriosis

Our plain-English summary of An incidental diagnosis of well-differentiated papillary mesothelioma in a woman operated on for recurrent endometriosis, by R. Mangal, O. Taskin, R. Franklin (Fertility and Sterility, 1995).

The study

• Authors: R. Mangal, O. Taskin, R. Franklin
• Journal: Fertility and Sterility
• Published: 1995;63(1):196-7
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The case presented involves a report of severe endometriosis with recurrent disabling dysmenorrhea associated with well-differentiated mesothelioma. Although the course of mesotheliomas is predominantly benign, the diversity of lesions, variable behavior, and resemblance, and association with endometriosis warrant thorough diagnostic investigation. Multiple biopsies and differential diagnoses are recommended in cases of peritoneal endometriosis.

In plain English

This was a case report from The Woman's Hospital of Texas and Baylor College of Medicine in Houston about one woman, aged 35, who had severe, disabling period pain. She was first diagnosed with endometriosis by laparoscopy in 1989. A second laparoscopy in 1992 followed a return of her pain. In 1993 a third laparoscopy found extensive adhesions, endometriosis, an ovarian endometrioma, and nodules on the omentum, the posterior cul-de-sac and the right ureteral area. These were removed by open surgery (laparotomy), which required removing and reattaching part of the right ureter. In the nodules, pathology found well-differentiated papillary mesothelioma, with focal atypia and multiple mitoses, alongside endometriosis and the endometrioma. A gynecological oncologist then followed her. Her pain improved but did not go away. Her father had previously been diagnosed with peritoneal mesothelioma, which the authors said may suggest an inherited tendency. The article did not mention asbestos. The authors recommended multiple biopsies and differential diagnoses in women with peritoneal endometriosis.

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
• Who was studied: One 35-year-old woman (one prior pregnancy, one birth) with recurrent endometriosis, treated at The Woman's Hospital of Texas and Baylor College of Medicine, Houston, Texas. She was diagnosed in 1989 and operated on again in 1992 and 1993.
• Exposure: No asbestos or other environmental or occupational exposure is described in the article. The authors noted that the patient's father had peritoneal mesothelioma.
• Main results:
  • At the 1993 operation, nodules were found on the omentum, the posterior cul-de-sac and the right ureteral area of this patient.
  • Removing the lesions in this patient required resection and reimplantation of the right ureter.
  • Pathology of this patient's nodules showed well-differentiated papillary mesothelioma with focal atypia and multiple mitoses, along with endometriosis and ovarian endometrioma.
  • After surgery, the patient's pain improved but some pain remained. She was being followed by a gynecological oncologist.
  • The patient's father had previously been diagnosed with peritoneal mesothelioma. The authors said this may suggest an inherited tendency.
• The authors' conclusion: The authors recommended multiple biopsies and differential diagnoses in cases of peritoneal endometriosis. They also said long-term follow-up studies appear warranted.

Topics

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

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Well-Differentiated, Mesothelioma.

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• Well-differentiated papillary mesothelioma of the epididymis in a man with recurrent haematospermia — L.R. Bonetti, L. Schirosi, et al. (2012)
• Incidental finding of multiple well-differentiated papillary mesotheliomas in peritoneum — M. Jakobsen, B. Engvad, et al. (2016)
• Well-Differentiated Papillary Mesothelioma With Two Synchronous Serous Gynaecologic Carcinomas in a 62-Year-Old Woman: Lessons Learned for the Gynaecologic Surgeon — J.M. McGinnis, V. Bloomfield, et al. (2020)
• Acute severe abdominal pain in a young woman caused by a well-differentiated papillary mesothelioma of the peritoneum — J.E. Bousema, K.M. van de Luijtgaarden, et al. (2019)
• Malignant transformation of well-differentiated papillary mesothelioma 13 years after the diagnosis: a case report — L. Costanzo, S. Scarlata, et al. (2014)

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