Colon cancers and peritoneal mesothelioma occurring 29 years after abdominal radiation for testicular seminoma. A case report and review of the literature

Our plain-English summary of Colon cancers and peritoneal mesothelioma occurring 29 years after abdominal radiation for testicular seminoma. A case report and review of the literature, by D. Tassile, A.D. Roth, A.M. Kurt, et al (Oncology, 1998).

The study

• Authors: D. Tassile, A.D. Roth, A.M. Kurt, A. Rohner, P. Morel
• Journal: Oncology
• Published: 1998;55(4):289-92
• Type of article: Case report, Review
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Secondary malignancies represent an increasing problem for long survivors of primary malignancies treated by chemo- and/or radiotherapy. The occurrence of secondary myelodysplasia and leukaemias after treatment for Hodgkin's disease is well established. Secondary solid tumors are mostly observed following radiation therapy. We report the case of a patient who presented 3 abdominal solid malignancies within 3 years, 29 years after abdominal radiotherapy for a testicular seminoma, namely 2 colon cancers and a peritoneal mesothelioma. Both types of cancer are independently reported in the literature to be more frequent in patients with a history of abdominal radiation than in the general population. To our knowledge there is no other reported case with 3, nearly simultaneously occurring separate solid tumors, which could all be related to former abdominal irradiation. Such a radiotherapy-related long-term side effect should be taken into account when considering adjuvant radiotherapy in patients with low-risk stage I testicular seminoma.

In plain English

This was a case report from Geneva University Hospital, Switzerland, with a short discussion of earlier published reports. The patient, a man born in 1939, was treated in 1963 for seminoma of the left testis. He had surgery followed by 35 sessions of abdominal radiotherapy, a total dose of 30 Gy. He had worked as a driver for a removal company and later as a clerk for an orchestra. The article does not say whether he was ever exposed to asbestos. In December 1992 he had surgery for colon cancer (an adenocarcinoma). In February 1994 an operation for bowel obstruction found a tumour mass at the root of the mesentery and in the pelvis, which was diagnosed as malignant mesothelioma of the peritoneum. He did not respond to cisplatin chemotherapy and died in December 1994. The autopsy found a separate cancer in the cecum and remaining mesothelioma. The authors concluded that, although the three tumours appearing 29 years after radiation could be coincidental, the case was highly suggestive of second cancers related to radiotherapy.

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 with a brief discussion of published literature
• Who was studied: one man, born in 1939, treated at Geneva University Hospital, Switzerland; formerly a driver for a removal company, then a clerk for an orchestra for over 20 years
• Exposure: abdominal radiotherapy (cobalt therapy), 35 sessions, total dose 30 Gy, given in 1963 after orchiectomy for testicular seminoma; the article does not report on asbestos exposure for this patient
• Main results:
  • In December 1992 the patient had a left hemicolectomy for colon cancer, a moderately well differentiated adenocarcinoma
  • In 1994, biopsies from an exploratory laparotomy for intestinal obstruction showed malignant mesothelioma of the peritoneum
  • On immunostaining, the tumour cells were positive for broad-spectrum keratin and negative for keratin 20, and about 10 to 20% were positive for vimentin, findings the authors described as compatible with malignant mesothelioma
  • The patient did not respond to cisplatin chemotherapy and died in December 1994
  • At autopsy there was a 2.5 cm mass in the cecum, and immunohistochemistry confirmed residual mesothelioma in the abdomen together with a well-differentiated adenocarcinoma of the cecum
• The authors' conclusion: The authors concluded that, although the case could be coincidental, it was highly suggestive of second cancers related to radiotherapy. They argued that this supports avoiding adjuvant radiation in low-risk stage I testicular seminoma.
• Limitations the authors state:
  • The authors acknowledged the tumours could be coincidental
  • The patient's family history was unknown, so the authors could not judge whether his colonic polyps reflected inherited susceptibility or radiation effects

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: Colorectal Cancer, Peritoneal Mesothelioma.

Related studies

• Long-term outcomes following post-operative radiotherapy for Stage I/II testicular seminoma - an Australasian single-institution experience — W.L. Ong, L. Nazareth, et al. (2016)
• Malignant peritoneal mesothelioma associated with deep vein thrombosis following radiotherapy for seminoma of the testis — F. Sato, H. Yamazaki, et al. (2000)
• Malignant peritoneal mesothelioma following radiotherapy for seminoma of the testis — R.J. Stock, Y.S. Fu, et al. (1979)
• Radiation-induced mesothelioma among long-term solid cancer survivors: a longitudinal analysis of SEER database — A. Farioli, M. Ottone, et al. (2016)
• Benign multicystic peritoneal mesothelioma presenting as a ghost abdominal mass — H. Jerraya, W. Ghariani, et al. (2016)
• A Case of Abdominal Discomfort Caused by Benign Multicystic Peritoneal Mesothelioma — T.G. Cotter, J.S. Van Arnam, et al. (2016)

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