Angiography of omental mesothelioma

Our plain-English summary of Angiography of omental mesothelioma, by K. Marini, J.F. Walter (AJR. American Journal of Roentgenology, 1984).

The study

• Authors: K. Marini, J.F. Walter
• Journal: AJR. American Journal of Roentgenology
• Published: 1984;143(5):1075-7
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Angiographic features of three cases of omental mesothelioma are presented. These lesions appeared mildly or moderately hypervascular without arteriovenous shunting or arterial encasement. The predominant feeding arteries were the right and left gastroepiploics. Since arteriography may be performed in the evaluation of the often nonspecific presenting symptoms of patients with abdominal mesothelioma, radiologists should be aware of these abnormalities.

In plain English

This article reported three cases of omental mesothelioma, a tumor of the omentum (the fatty tissue apron in the abdomen). It described how the tumors looked on arteriograms, which are X-ray images of blood vessels. The patients were men aged 59, 55 and 64, and none had known asbestos exposure. In the first man, the arteriogram was initially read as normal, and the diagnosis was made at autopsy 9 months later. Reviewing the images afterward, the authors saw dilated omental arteries and barely visible new tumor vessels. Recognizing this pattern let them suggest the diagnosis before surgery in the other two men, and surgery confirmed it in both. These men died 4 and 6 months later. All three tumors were mildly or moderately hypervascular (richer in blood vessels than normal). None showed arterial encasement or arteriovenous shunting. The authors noted the findings were not absolutely specific, since similar artery enlargement may follow abdominal surgery or peritonitis. They concluded that the possibility could be strongly suggested when these imaging and clinical features occur together.

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 series (three case reports) describing angiographic findings
• Who was studied: Three men with omental mesothelioma, aged 59, 55 and 64; the authors were at the Palo Alto Medical Foundation; dates of the cases were not given
• Exposure: No asbestos exposure was studied; the authors reported that none of the three patients had known asbestos exposure
• Main results:
  • Case 1 (59-year-old man): arteriography was initially read as normal; omental and peritoneal mesothelioma was diagnosed at autopsy 9 months later
  • Case 1: on later review, the arteriogram showed dilated omental arterial branches and some barely appreciable new tumor vessels
  • Case 2 (55-year-old man): based on the angiographic findings, omental mesothelioma was diagnosed before surgery and confirmed at surgery
  • Case 2: the patient died of massive lung metastases 4 months later
  • Case 3 (64-year-old man): omental mesothelioma was suggested from the arteriogram and confirmed at surgical exploration; he died 6 months later
  • All three tumors were mildly or moderately hypervascular, supplied by dilated branches of the gastroepiploic arteries
  • None of the three had arterial encasement or arteriovenous shunting; one had dilated omental veins
• The authors' conclusion: The authors concluded that, although the angiographic findings are not absolutely specific, they can strongly suggest omental mesothelioma when they occur together with the clinical features
• Limitations the authors state:
  • Enlargement of these arteries can also be seen in patients with previous abdominal surgery or peritonitis
  • Similar artery enlargement might be seen when other cancers spread to the omentum
  • The role of CT scanning was not defined; CT was done in only one case and was not helpful

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.

Related studies

• CT-guided core-needle biopsy in omental pathology — F. Pombo, E. Rodriguez, et al. (1997)
• Extragastrointestinal Stromal Tumor Presenting as Omental Cyst — A. Monabati, M. Safavi, et al. (2016)
• Surgical biopsy studies of omental and peritoneal nodules — D.B. Walsh, G. Williams (1971)
• Primary omental mesothelioma: a rare but important differential diagnosis in previous asbestos exposure — A. Harb, E. King, et al. (2010)
• Pleuroma--a cancer-mimicking atelectatic pseudotumor of the lung. 55 consecutive cases studied by high KV radiography, bronchography, selective pulmonary angiography and needle biopsy — W.N. Sinner (1980)
• Neoplastic and inflammatory processes of the peritoneum, omentum, and mesentery: diagnosis with CT — J.E. Hamrick-Turner, M.V. Chiechi, et al. (1992)

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