Clinical, histologic, and genetic features of mesothelioma in a 7-year-old child

Our plain-English summary of Clinical, histologic, and genetic features of mesothelioma in a 7-year-old child, by A. Sugalski, M. Davis, L. Prasannan, et al (Pediatric Blood & Cancer, 2013).

The study

• Authors: A. Sugalski, M. Davis, L. Prasannan, V. Saldivar, J.Y. Hung, G.E. Tomlinson
• Journal: Pediatric Blood & Cancer
• Published: 2013;60(1):146-8
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma (MM) is a highly aggressive malignancy that is extremely rare in children. This case report documents a 7-year-old male without previous asbestos exposure with peritoneal MM that initially responded to chemotherapy with cisplatin and gemcitabine but ultimately metastasized to his chest. He was diagnosed with MM based on histology, extensive immunohistochemical analyses, and an elevated serum CA-125 level. Cytogenetics and comparative genomic hybridization (CGH) analysis of his tumor identified a single extra copy number of chromosome 11 with few other changes noted.

Copyright © 2012 Wiley Periodicals, Inc.

In plain English

This brief report described one patient: a 7-year-old Hispanic boy with malignant mesothelioma of the peritoneum, the lining of the abdomen. There was no known asbestos exposure for the patient or his family. He had two months of abdominal pain and weight loss, and scans showed the disease was confined to the peritoneal cavity. His blood level of the marker CA-125 was markedly raised at 841.6 U/ml (normal below 35). Tissue staining supported a diagnosis of mesothelioma. Chromosome analysis found an extra copy of chromosome 11 (trisomy 11) in all 15 cells studied, with few other changes. Treatment with cisplatin and gemcitabine at first lowered CA-125 to 209 and then 43.9 U/ml, with partial shrinkage of the tumor. The disease then spread to the right chest and armpit. A second treatment, cisplatin with pemetrexed, could not be continued, and the boy died 11 months after diagnosis. The authors concluded that this initial response, together with two patients described in an earlier report, justified further consideration of cisplatin and gemcitabine, though additional agents are needed.

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 (brief report of a single patient)
• Who was studied: One 7-year-old Hispanic boy with peritoneal malignant mesothelioma, treated in Texas (authors from San Antonio, Grand Rapids and Lubbock hospitals); dates of treatment not given
• Exposure: No known asbestos exposure for the patient or his family; no family history of neurofibromatosis or other cancers
• Main results:
  • Scans, bone marrow tests and bone scan showed the disease was confined to the peritoneal cavity
  • Serum CA-125 was markedly elevated at 841.6 U/ml (normal less than 35 U/ml); AFP, beta-hCG, CA-19-9, CEA and soluble mesothelin were normal
  • Tumor staining was positive for WT1, CK 5/6, calretinin, CAM 5.2 and mesothelin and negative for CEA, TTF1, PR and ER, supporting a diagnosis of mesothelioma
  • Trisomy 11 (an extra copy of chromosome 11) was found in all 15 tumor cells studied and confirmed by CGH; small deletions were found at 19q13.33, 15q15.1 and 16p13, with no copy number abnormalities in the NF-2 or BAP1 genes
  • Cisplatin 75 mg/m2 plus gemcitabine 1,250 mg/m2 was well tolerated. After two cycles serum CA-125 fell from 841.6 to 209 U/ml with partial radiographic response. After four cycles it fell to 43.9 U/ml, but nodules appeared on the lining of the right chest.
  • After six cycles a new mass in the right armpit and thickening of the right chest lining consistent with metastases appeared. After one course of cisplatin and pemetrexed, the patient could not tolerate further therapy and died of progressive disease 11 months after diagnosis.
• The authors' conclusion: The authors concluded that the initial response in this patient, together with two patients in an earlier report who were alive at 45 and 57 months, provides evidence justifying further consideration of cisplatin/gemcitabine in mesothelioma. They added that additional agents are clearly needed.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Chemotherapy, Cisplatin, Gemcitabine, Histology, CA-125.

Related studies

• Malignant biphasic peritoneal mesothelioma in a child: fine-needle aspiration cytology, histopathology, and immunohistochemical features along with review of literature — S.K. Arora, R. Srinivasan, et al. (2012)
• An 8-Year-Old Child with Malignant Deciduoid Mesothelioma of the Abdomen: Report of a Case and Review of the Literature — M. Wolff-Bar, T. Dujovny, et al. (2015)
• Solitary benign fibrous mesothelioma of the peritoneum: A rare entity in a 2-year-old child — S. Singh, M. Sangwan, et al. (2016)
• Diffuse Pleural Mesotheliomas with Genomic Near-Haploidization: A Newly Recognized Subset with Distinct Clinical, Histologic, and Molecular Features — S.R. Yang, G. Jayakumaran, et al. (2024)
• Peritoneal Mesothelioma with Residential Asbestos Exposure. Report of a Case with Long Survival (Seventeen Years) Analyzed by Cgh-Array — G. Serio, F. Pezzuto, et al. (2017)
• Successful one-lung ventilation by blocking the right intermediate bronchus in a 7-year-old child: a case report — S.Y. Baek, J.H. Kim, et al. (2019)

Browse more research in Pediatric Blood & Cancer, or return to medical research.