Deciduoid pleural mesothelioma in an adolescent

Our plain-English summary of Deciduoid pleural mesothelioma in an adolescent, by E. Arango-Tomás, F.J. Algar-Algar, A. Salvatierra Velázquez (Archivos de Bronconeumología, 2013).

The study

• Authors: E. Arango-Tomás, F.J. Algar-Algar, A. Salvatierra Velázquez
• Journal: Archivos de Bronconeumología
• Published: 2013;49(5):218-9
• Type of article: Case report, Letter
• Language: Spanish
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter to the editor described a case of deciduoid pleural mesothelioma, a rare variant of epithelioid mesothelioma, in a 17-year-old patient. The authors considered the case unusual because of the patient's age and absence of prior history. The patient had a persistent non-productive cough that did not improve with antibiotics and analgesics. Blood tests showed microcytic hypochromic anaemia, thrombocytosis and elevated C-reactive protein. CT showed a 9 cm heterogeneous solid mass in the left upper lobe. MRI showed that the mass was extrapulmonary, arose from the pleura, infiltrated the mediastinum and partly surrounded the origin of the left subclavian artery. PET showed a maximum SUV of 8.55, with no mediastinal uptake. Fine-needle aspiration found malignant cells. Surgical biopsy confirmed infiltration of the mediastinum, aortic arch and aortopulmonary window. On pathology the large epithelial cells were positive for cytokeratin AE1/AE3, calretinin, WT-1 and EMA, consistent with deciduoid epithelial pleural mesothelioma. The IMIG stage was T3-N0-M0 (stage III). Extrapleural pneumonectomy was ruled out, and the patient received cisplatin and pemetrexed, with survival of 21 months at the time of writing. The authors noted that 23 pleural cases had been published, that 68% of patients die within the first year, and that this subtype is not related to asbestos exposure. They concluded that cytoreduction can be offered to patients without nodal involvement, with neoadjuvant cisplatin and pemetrexed recommended in advanced stages.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This letter to the editor, from a thoracic surgery unit in Córdoba, Spain, described one case of deciduoid pleural mesothelioma, a rare variant of epithelioid mesothelioma, in a 17-year-old patient. The patient had a persistent dry cough that did not improve with antibiotics and pain medication. Blood tests showed anemia, a high platelet count and raised C-reactive protein. Scans showed a 9 cm mass arising from the pleura in the upper left chest. It was growing into the mediastinum and partly surrounding the left subclavian artery. A needle sample and a surgical biopsy found malignant cells, and tissue staining fitted epithelial pleural mesothelioma of deciduoid type, stage T3-N0-M0 (stage III). Radical surgery (extrapleural pneumonectomy) was ruled out, and chemotherapy with cisplatin and pemetrexed was started. At the time of writing, the patient had survived 21 months. The authors called the case unusual because of the patient's age and the absence of prior history, but did not say what that history covered. They stated that this variant has an uncertain cause unrelated to asbestos exposure. The authors concluded that cytoreductive surgery can be offered to such patients without lymph node involvement, recommending neoadjuvant cisplatin and pemetrexed in advanced stages.

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 (letter to the editor) describing a single patient
• Who was studied: One 17-year-old patient with a persistent non-productive cough, treated at Hospital Universitario Reina Sofía, Córdoba, Spain; no dates given
• Exposure: No asbestos exposure is reported for this patient. The authors describe the case as unusual because of age and absence of prior history, without saying what that history covered. They state that deciduoid mesothelioma has an uncertain cause unrelated to asbestos exposure.
• Main results:
  • Blood tests in the patient showed hypochromic microcytic anemia, thrombocytosis and elevated C-reactive protein
  • Chest CT showed a 9 cm heterogeneous solid mass in the left upper lobe. MRI defined it as extrapulmonary and derived from the pleura, infiltrating the mediastinum.
  • PET showed the mass was hypermetabolic, with a maximum SUV of 8.55 (printed 8,55) and no mediastinal uptake
  • At surgery for biopsy, infiltration of the mediastinum, aortic arch and aortopulmonary window was confirmed
  • Pathology and staining were consistent with epithelial pleural mesothelioma of deciduoid type, clinical stage T3-N0-M0 (stage III) by IMIG criteria
  • Extrapleural pneumonectomy was ruled out. Chemotherapy with cisplatin and pemetrexed was started, and the patient had survived 21 months at the time of writing.
• The authors' conclusion: The authors concluded that cytoreductive surgery can be offered to patients with deciduoid malignant mesothelioma without lymph node involvement, recommending neoadjuvant cisplatin and pemetrexed in advanced stages

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Epithelioid, Mesothelioma, Non-Productive Cough, Pleura, Mediastinum, Fine-Needle Aspiration, Biopsy.

Related studies

• Therapeutic strategies for well-differentiated papillary mesothelioma of the peritoneum — Y.K. Lee, H.J. Jun, et al. (2013)
• Deciduoid mesothelioma of the pleura in an adolescent boy — L.Y. Tsai, Y.L. Yang, et al. (2010)
• Continued pemetrexed and platin-based chemotherapy in patients with malignant pleural mesothelioma (MPM): value of 18F-FDG-PET/CT — N.G. Schaefer, P. Veit-Haibach, et al. (2012)
• Future developments in the management of malignant pleural mesothelioma — P.A. Zucali, F. De Vincenzo, et al. (2009)
• Soluble mesothelin, megakaryocyte potentiating factor, and osteopontin as markers of patient response and outcome in mesothelioma — K. Hollevoet, K. Nackaerts, et al. (2011)
• Gingival metastasis as first sign of multiorgan dissemination of epithelioid malignant mesothelioma — A. Billè, M. Platania, et al. (2014)

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