Asbestosis, laryngeal carcinoma, and malignant peritoneal mesothelioma in an insulation worker

Our plain-English summary of Asbestosis, laryngeal carcinoma, and malignant peritoneal mesothelioma in an insulation worker, by A. Fischbein, J.C. Luo, G.R. Pinkston (British Journal of Industrial Medicine, 1991).

The study

• Authors: A. Fischbein, J.C. Luo, G.R. Pinkston
• Journal: British Journal of Industrial Medicine
• Published: 1991;48(5):338-41
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004154).

Abstract

Asbestos associated diseases consist of both benign and malignant conditions. A rare constellation of asbestosis, laryngeal carcinoma, and malignant peritoneal mesothelioma occurring in a patient with long term occupational exposure to airborne asbestos fibres is presented. The observation illustrates the powerful disease-causing potential of occupational exposure to asbestos. A brief discussion of multiple primary neoplasms associated with exposure to asbestos is also presented.

In plain English

This article was a case report of one man, born in 1921, who worked as an insulator from 1942 to 1973. He routinely handled asbestos-containing insulation, applying and removing it in shipyards, paper mills, powerhouses and other industrial sites. He also smoked 30 cigarettes a day from 1936 to 1967, later smoked cigars and chewed tobacco, and drank about six cans of beer a day for several years. In August 1983 a biopsy showed squamous cell carcinoma of the right vocal cord, a cancer of the larynx. In December 1983 his abdomen swelled, and a biopsy showed diffuse peritoneal mesothelioma. He died in May 1984. At autopsy, asbestos bodies were found in both lungs but not in either tumour, and no evidence of metastatic carcinoma was found. Chest X-rays from 1980 to 1983 showed lung scarring and pleural thickening. The authors found no earlier reported case with this combination. They saw little reason to question the link between the mesothelioma and his asbestos exposure, given his severe asbestosis. They judged smoking, alcohol and asbestos all likely contributors to the laryngeal cancer. They noted that a single case can be a random event.

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 (one patient), with a brief discussion of published literature on multiple primary cancers and on asbestos and laryngeal cancer
• Who was studied: one man born in 1921, an insulation worker; he was diagnosed in 1983 and died in May 1984
• Exposure: Occupational exposure to asbestos-containing insulation materials as an insulator from 1942 to 1973. He applied thermal insulation to pipes and pressure vessels and removed old insulation in shipyards, paper mills, powerhouses and other industrial facilities. No fiber type was specified. He also had heavy tobacco use and alcohol use.
• Main results:
  • In August 1983, a vocal cord biopsy showed well differentiated squamous cell carcinoma of the right vocal cord (laryngeal cancer).
  • After abdominal swelling in December 1983, exploratory surgery and an omental biopsy showed diffuse peritoneal mesothelioma.
  • The patient had a rapidly progressive course and died in May 1984.
  • At autopsy, the lungs were encased by partly calcified pleural plaques. Considerable interstitial fibrosis was present in both lungs.
  • At autopsy, asbestos bodies were found in both lungs but not in either tumour. No evidence of metastatic carcinoma was found, and mesothelioma was not found in the chest cavity.
  • Chest X-rays taken between December 1980 and August 1983 showed extensive lung scarring, graded s/t 2/3 on the International Labour Office classification. They also showed pleural thickening graded b3 on the right and b2 on the left, with calcifications.
  • The patient smoked 30 cigarettes a day from 1936 to 1967 and smoked cigars from 1967 to 1981. He chewed tobacco for most of his adult life and drank about six cans of beer a day for several years.
  • The mesothelioma became clinically evident three months after the laryngeal cancer was diagnosed. Both cancers developed about 40 years after he began work in the asbestos-related trade.
  • The authors were unable to find any previously reported case of peritoneal mesothelioma and laryngeal cancer occurring together.
• The authors' conclusion: The authors saw little reason to question the association between the mesothelioma and the patient's occupational asbestos exposure, especially given his severe asbestosis. For the laryngeal cancer, they suggested that tobacco smoking, alcohol consumption and asbestos exposure were all likely contributory factors. They presented the case as an illustration of what they called the powerful disease-causing potential of occupational asbestos exposure.
• Limitations the authors state:
  • The authors acknowledged that an observation in a single case can be a random event.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma, Peritoneal mesothelioma, Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Carcinoma, Peritoneal Mesothelioma, Insulator, Occupational Exposure, Neoplasm.

Related studies

• Current theories for the development of nonsmoking and nondrinking laryngeal carcinoma — R. Wight, V. Paleri, et al. (2003)
• Whole exome sequencing of independent lung adenocarcinoma, lung squamous cell carcinoma, and malignant peritoneal mesothelioma: A case report — I. Vanni, S. Coco, et al. (2016)
• Asbestos and laryngeal carcinoma — P.M. Stell, T. McGill (1973)
• Exposure to asbestos and laryngeal carcinoma — P.M. Stell, T. McGill (1975)
• Asbestos fibers in laryngeal tissues. Findings in two patients with asbestosis associated with laryngeal tumors — A. Hirsch, J. Bignon, et al. (1979)
• Metastatic laryngeal carcinoma mimicking pleural mesothelioma — M. Huncharek, J. Muscat (1991)

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