An unusual liver mass: primary malignant mesothelioma of the liver : CT and MRI findings and literature review

Our plain-English summary of An unusual liver mass: primary malignant mesothelioma of the liver : CT and MRI findings and literature review, by A. Serter, N. Buyukpinarbasili, O. Karatepe, et al (Japanese Journal of Radiology, 2015).

The study

• Authors: A. Serter, N. Buyukpinarbasili, O. Karatepe, E. Kocakoc
• Journal: Japanese Journal of Radiology
• Published: 2015;33(2):102-6
• Type of article: Case report, Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Primary malignant mesothelioma of the liver is extremely rare, and radiologic features have been defined in only one case. We present radiologic findings of two cases which are pathologically proven as primary malignant mesothelioma of the liver. Malignant mesothelioma of the liver may be included in a differential diagnosis list if there is a heterogeneous, hemorrhagic and necrotic lesion in the liver, with peripheral serpiginous vascular structures and increasing septal enhancement in post-contrast images.

In plain English

This article was a case report of two patients whose liver tumors were confirmed by pathology as primary malignant mesothelioma of the liver. It also included a brief look at earlier published reports. The authors stated that neither patient had a history of asbestos exposure. The first patient, a 56-year-old woman with weakness, abdominal pain and anemia, had a 150 × 110 × 100 mm mass in the liver. The mass contained bleeding, thick internal walls (septations) and dead tissue (necrosis). On CT and MRI scans taken after contrast dye, winding blood vessels appeared at the edge of the mass, and the septations lit up more strongly on later images. The second patient, a 66-year-old man with abdominal pain for 7 years and 35 kg weight loss, had a liver mass that measured 185 × 124 mm on CT two months after his first scan. It was removed in surgery. Pathologists classified both tumors as the epithelioid type. The authors concluded that this tumor may be considered when a liver mass shows these imaging features.

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 two patients, with a brief literature review
• Who was studied: Two patients with primary malignant mesothelioma of the liver: a 56-year-old woman (Case 1) and a 66-year-old man (Case 2), seen at the authors' hospital. The authors are at Bezmialem Vakif University, Istanbul, Turkey. Dates of care are not given.
• Exposure: No asbestos exposure was reported for either patient. The article studied imaging features (ultrasound, CT, MRI, PET-CT) of the tumor, not an exposure.
• Main results:
  • Case 1: multiphasic CT showed a 150 × 110 × 100 mm hypodense mass involving liver segments 4A, 8 and 7, with hemorrhage, thick septations and central necrotic areas.
  • Case 1: on post-contrast CT and MRI, peripheral serpiginous (winding) vascular structures were seen, and peripheral septal enhancement increased on portal and venous phase images.
  • Case 1: at surgery, extensive ascites and omental cake were found. Only liver and omentum biopsies were taken.
  • Case 2: a 66-year-old man with abdominal pain for 7 years and 35 kg weight loss had a mass that measured 185 × 124 mm on CT two months after initial imaging. PET-CT showed increased FDG uptake (SUV max 13.5) except in central necrotic areas.
  • Case 2: the tumor showed three histologic components: 50 % tubulopapillary, 40 % solid and 10 % sarcomatoid.
  • Case 2: the findings were consistent with an epithelioid type hepatic malignant mesothelioma arising from Glisson's capsule (the liver's outer covering).
  • Both cases were the epithelioid type.
• The authors' conclusion: The authors concluded that malignant mesothelioma of the liver may be included in a differential diagnosis when a liver lesion is heterogeneous, hemorrhagic and necrotic, with peripheral serpiginous vascular structures and increasing septal enhancement on post-contrast images.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Differential Diagnosis.

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