Benign fibrous mesothelioma successfully treated by thoracoscope-assisted surgery: report of a case

Our plain-English summary of Benign fibrous mesothelioma successfully treated by thoracoscope-assisted surgery: report of a case, by A. Nakao, K. Sakagami, M. Uda, et al (Surgery Today, 1998).

The study

• Authors: A. Nakao, K. Sakagami, M. Uda, S. Mitsuoka, H. Ito
• Journal: Surgery Today
• Published: 1998;28(10):1087-90
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report herein the case of an 84-year-old man in whom a benign fibrous mesothelioma (BFM) was successfully treated by thoracoscope-assisted surgery. In September 1996, the patient underwent a sigmoidectomy for colon cancer, soon after which a followup examination disclosed a coin lesion on his chest X-ray film. The patient was readmitted to our hospital in November 1996 for further investigation of this tumor. A chest computed tomography scan revealed a 3.5 x 3.0 cm homogeneous tumor arising from the pleura. A needle biopsy was performed under ultrasonographic guidance, and the specimen was histopathologically diagnosed as a BFM. In view of his poor respiratory function, the tumor was excised by thoracoscope-assisted surgery. This case report serves to demonstrate the benefits of thoracoscope-assisted surgery for such patients.

In plain English

This article was a case report about one patient: an 84-year-old man treated at Shobara Red Cross Hospital in Japan. In September 1996 he had surgery to remove part of his colon (a sigmoidectomy) for a perforated sigmoid colon cancer. A follow-up chest X-ray then showed a nodular shadow, which was first thought to be cancer that had spread to the lung. A CT scan showed a 3.5 by 3.0 cm mass next to the pleura (the lining around the lung), without invasion of the chest wall. A needle biopsy guided by ultrasound diagnosed a benign fibrous mesothelioma. His lung function was limited, and he had recently had colon surgery. For these reasons the authors chose thoracoscope-assisted surgery, which they described as minimally invasive and leaving small scars, and removed the tumor on January 16, 1997. The tumor measured 2.8 by 3.0 by 3.1 cm, and the surgical edges were free of tumor. He had no recurrence 6 months after the operation. The article did not say whether this patient had been exposed to asbestos. The authors concluded that thoracoscope-assisted surgery can be very useful for this tumor, even in compromised patients.

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 patient) with a brief literature review
• Who was studied: One 84-year-old man admitted to Shobara Red Cross Hospital, Japan, on September 10, 1996, with a perforated sigmoid colon cancer, later found to have a pleural tumor
• Exposure: The article does not say whether the patient was exposed to asbestos. As general background, the discussion states that the diffuse, highly malignant type of mesothelioma is often associated with asbestosis. That type is not the benign fibrous type described in this case.
• Main results:
  • After the colon surgery, a nodular shadow was found on the patient's follow-up chest X-ray. It was first interpreted as lung metastasis of the colon cancer.
  • CT showed a 3.5 by 3.0 cm mass next to the pleural surface, without chest wall invasion.
  • The patient's pulmonary function was limited, with a forced expiratory volume in 1 second of 57%.
  • An ultrasound-guided needle biopsy specimen was diagnosed as benign fibrous mesothelioma (BFM).
  • The authors chose thoracoscope-assisted surgery because of the patient's restricted respiratory function and his sigmoidectomy 4 months earlier.
  • Thoracoscope-assisted surgery was performed on January 16, 1997, with local excision and a 1-cm tumor margin.
  • The removed tumor measured 2.8 by 3.0 by 3.1 cm.
  • The surgical margins were free of tumor cells.
  • The tumor cells tested positive for vimentin, but not for S-100 protein or keratin.
  • The patient remained free of recurrence for 6 months after the operation.
• The authors' conclusion: The authors concluded that thoracoscope-assisted surgery can be very useful for benign fibrous mesothelioma, even in compromised patients.

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, Colorectal Cancer, Chest X-Ray, Pleura, Needle Biopsy.

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