Deciduoid mesothelioma of the pleura in an adolescent boy

Our plain-English summary of Deciduoid mesothelioma of the pleura in an adolescent boy, by L.Y. Tsai, Y.L. Yang, M.Y. Lu, et al (Pediatric Hematology and Oncology, 2010).

The study

• Authors: L.Y. Tsai, Y.L. Yang, M.Y. Lu, D.T. Lin, H.Y. Huang, K.H. Lin
• Journal: Pediatric Hematology and Oncology
• Published: 2010;27(2):132-7
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Deciduoid mesothelioma is an extremely rare variant of malignant epithelioid mesothelioma. This report presents the case of a 13-year-old boy with this type of tumor in his pleura, whose initial main symptoms were chest pains and progressive scoliosis. Ensuing chemotherapy, which comprised pemetrexed and cisplatin, yielded good response after 5 cycles. Subsequent radical surgery was carried out and another 3 cycles of chemotherapy were given. The patient has been doing well 2 years after completion of this regime of treatment.

In plain English

This case report described one 13-year-old boy with deciduoid mesothelioma of the pleura, which the authors called an extremely rare variant of malignant epithelioid mesothelioma. He had right-sided chest pains for over five months and developed scoliosis, with fluid around the right lung. A small nodule on the lining of the chest wall was found and removed, and tissue tests led to the diagnosis. The article reported no past or family history of asbestos exposure. Because his parents worried about chemotherapy side effects, he first received prednisolone and etoposide. His pain eased, but the tumor progressed. He then received pemetrexed with cisplatin for five cycles. This was followed by surgery that removed his right lung, most of the pleura and part of the lower esophagus, and then three more cycles. One of 9 lymph nodes examined contained mesothelioma. Two years after finishing treatment he was doing reasonably well. The authors concluded that their report offers first-hand experience in treating this tumor in a child. A single case cannot show how often such treatment works.

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)
• Who was studied: One 13-year-old boy with deciduoid mesothelioma of the pleura; the authors are at National Taiwan University Hospital, Taipei, Taiwan; dates of care not stated
• Exposure: No asbestos exposure reported: the article states there was no past or family history of asbestos exposure
• Main results:
  • The boy had chest pains in his right intercostals for over 5 months. Three months after the pains began, his trunk began to deviate to the right, and examination showed obvious scoliosis.
  • Video-assisted thoracoscopy located a single nodule of about 0.4 × 0.3 × 0.3 cm on the parietal pleura, and a pleurectomy was performed.
  • The atypical cells were strongly cytokeratin (AE1:AE3) positive, with focal staining for calretinin, CD15 and smooth muscle stain. They were negative for WT-1, cytokeratin 5/6 and other markers. The pathological diagnosis was deciduoid mesothelioma.
  • The first treatment was prednisolone and etoposide, given for a total of 38 weeks, and it reduced the chest pains. However, 7 months after treatment started, chest CT showed progressive pleural thickening and nodular mass lesions.
  • After 5 cycles of pemetrexed (500 mg/m2) plus cisplatin (75 mg/m2), the boy had radical surgery: right pneumonectomy, subtotal pleurectomy, and wedge resection of the lower portion of the esophagus.
  • After surgery, the visceral pleura fibrosis no longer showed evidence of malignancy. Only 1 out of 9 hilar lymph nodes was consistent with metastatic mesothelioma.
  • After another 3 cycles of chemotherapy, the patient was doing reasonably well two years after completing therapy.
• The authors' conclusion: The authors concluded that their report offers first-hand experience in treating this extremely rare type of mesothelioma in a pediatric patient with the adult standard regimen of cisplatin plus pemetrexed. They stated that case series and treatment outcomes for this disease should be reported.

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, Pleura, Epithelioid, Chemotherapy, Pemetrexed (Alimta), Cisplatin.

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• Mesothelioma in children and adolescents: the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) contribution — D. Orbach, N. André, et al. (2020)
• An Autopsy Case Report of Malignant Pleural Mesothelioma with Deciduoid Features — R. Ushio, M. Yamamoto, et al. (2015)
• Deciduoid mesothelioma: report of 21 cases with review of the literature — N.G. Ordóñez (2012)
• Malignant Mesothelioma With EWSR1-ATF1 Fusion in Two Adolescent Male Patients — H. Ren, S.R. Rassekh, et al. (2021)

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