Benign multicystic mesothelioma with concurrent colonic adenocarcinoma: a report of two cases

Our plain-English summary of Benign multicystic mesothelioma with concurrent colonic adenocarcinoma: a report of two cases, by A. Husain, M. Ozdemirli (Surgery Today, 2012).

The study

• Authors: A. Husain, M. Ozdemirli
• Journal: Surgery Today
• Published: 2012;42(10):978-82
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Benign multicystic mesothelioma (BMM) is a rare tumoral lesion of the peritoneum often discovered incidentally upon surgery, laparoscopy, or radiographical imaging in females of childbearing age. The etiology and question as to whether these lesions occur via a neoplastic or reactive process still remain unknown. In this report, we present two cases of BMM detected in females with concurrent colonic adenocarcinoma arising in the ileocecal region. The tumors were present in the serosa surrounding the colonic adenocarcinoma in one case, and in the omentum in the other case, which grossly mimicked peritoneal seeding of carcinoma. An immunohistochemical analysis revealed that the cells lining the cystic spaces in both lesions were positive for keratin and calretinin, confirming their mesothelial origin. To the best of our knowledge, these cases represent the first documented examples of multicystic mesothelioma concurrent with colonic adenocarcinoma.

In plain English

This case report described two women in whom benign multicystic mesothelioma, a rare cystic lesion of the peritoneum, was found together with colon cancer (adenocarcinoma) arising in the ileocecal region. The article does not mention asbestos or any other exposure. The first patient, a 58-year-old woman with prior abdominal surgery, had colon cancer that had spread to four pericolic lymph nodes. Cystic lesions lay in the tissue around the colon and on its outer surface. Their lining cells tested positive for keratin and calretinin, showing mesothelial origin, and also for p53. She later received chemotherapy and was reported to be in remission. The second patient, a 56-year-old African-American woman, had colon cancer spread to five of seven pericolic lymph nodes and to the liver. A cystic lesion in her omentum tested positive for keratin, cytokeratin-7 and calretinin. No follow-up was available for her. In both women the lesions looked to the naked eye like spread of cancer. The authors stated these were, to their knowledge, the first such cases reported. They concluded it remains controversial whether these lesions are reactive or neoplastic, and called for long-term follow-up.

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 (two cases)
• Who was studied: Two women with benign multicystic mesothelioma and colonic adenocarcinoma: a 58-year-old woman and a 56-year-old African-American woman. The authors are from Georgetown University Hospital, Washington, D.C. Dates of the cases are not given.
• Exposure: Not reported. The article does not mention asbestos or any other exposure.
• Main results:
  • Case 1 (58-year-old woman): invasive colonic adenocarcinoma at the ileocecal valve, with four of the pericolic lymph nodes positive for metastasis (pT3 N2a).
  • Case 1: the cells lining the cystic spaces in the pericolonic soft tissue and colonic serosa were positive for keratin and calretinin and negative for CD68, confirming mesothelial origin. They were also positive for p53.
  • Case 1: after surgery the patient received chemotherapy for colonic adenocarcinoma and was reported to be in remission.
  • Case 2 (56-year-old woman): colonic adenocarcinoma at the ileocecal valve, with metastasis in five of seven pericolic lymph nodes and in the liver.
  • Case 2: the cells lining the cystic spaces in the omental specimen were positive for keratin, cytokeratin-7 and calretinin, and negative for CEA, cytokeratin-20, p53 and S-100.
  • Case 2: no further follow-up data were available after discharge.
  • In both cases, the benign multicystic mesothelioma looked to the naked eye like peritoneal spread of metastatic carcinoma.
• The authors' conclusion: The authors stated that, to their knowledge, these were the first cases of benign multicystic mesothelioma reported together with colonic adenocarcinoma. They said it remains controversial whether these lesions are reactive or neoplastic. The lesion adherent to the carcinoma in Case 1 was consistent with a reactive process, while its p53 positivity was suggestive of a neoplastic process. They concluded that the uncertainty about origin and the high recurrence rate indicate the need for long-term follow-up.
• Limitations the authors state:
  • The authors noted there is no evidence that the lesion was present in Case 1 before the colon cancer developed.
  • The authors noted that the true frequency of this combination may be higher, because such lesions may not be biopsied.

Topics

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

Medical terms in this study, explained in our Lexicon: Multicystic Mesothelioma (MCM), Adenocarcinoma, Peritoneum, Etiology, Omentum, Carcinoma, Calretinin.

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• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)
• Laparoscopic diagnosis and treatment of pelvic benign multicystic mesothelioma associated with high CA19.9 serum concentration — V. Pinto, A.C. Rossi, et al. (2010)
• A recurrence of benign multicystic peritoneal mesothelioma treated through laparoscopic excision: a case report and review of the literature — T.D. Witek, J.W. Marchese, et al. (2014)
• Benign Multicystic Peritoneal Mesothelioma: AIRP Best Cases in Radiologic-Pathologic Correlation — R. Lee, A. Tong, et al. (2016)

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