Desmoplastic malignant mesothelioma originating from the peritoneum

Our plain-English summary of Desmoplastic malignant mesothelioma originating from the peritoneum, by H. Takamaru, Y. Arimura, Y. Shinomura (Medical Oncology, 2012).

The study

• Authors: H. Takamaru, Y. Arimura, Y. Shinomura
• Journal: Medical Oncology
• Published: 2012;29(5):3155-6
• Type of article: Case report, Letter
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter to the editor described a case of desmoplastic malignant mesothelioma arising from the peritoneum, which the authors called an extremely rare disease entity. The authors were from Sapporo Medical University, Japan. A 74-year-old man presented in February 2008 with progressive abdominal distension due to an enlarging abdominal mass. Soluble interleukin-2 receptor was slightly elevated (452 U/mL), and the other tumor markers examined were normal. CT and MRI showed a lipid-rich, ill-defined, non-enhancing tumor that appeared to originate from the small bowel mesentery. Exploratory laparotomy found disseminated small white nodules in the mesentery. Histology showed spindle-like tumor cells with collagenous fibers in a storiform pattern, leading to a diagnosis of desmoplastic mesothelioma. The tumor cells were positive for vimentin, smooth muscle actin and D2-40, and negative for calretinin, WT-1, desmin, CD34 and S-100. FISH analysis excluded a p16 deletion. Combination chemotherapy with irinotecan or gemcitabine plus cisplatin was ineffective. Intraperitoneal cisplatin was then given for 15 courses until the disease progressed. The patient received supportive care and survived 49 months after diagnosis. The authors stated that this was the first report of the disease since the WHO defined it in 2004, and that they had found only one earlier report, from 1982. They concluded that earlier intervention may contribute to longer survival, and that clinicians should consider malignant mesothelioma despite its rarity.

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 was a case report about one patient. A 74-year-old man came to the authors' hospital in February 2008 with a growing abdominal mass that was making his abdomen swell. CT and MRI scans showed a poorly defined tumor that seemed to start in the mesentery, the tissue that holds the small bowel in place. Exploratory surgery found many small white nodules there. Examination of the tissue led to a diagnosis of desmoplastic mesothelioma, a rare type of mesothelioma, here arising in the peritoneum, the lining of the abdomen. Chemotherapy with irinotecan or gemcitabine combined with cisplatin did not work. He then received cisplatin into the abdomen for 15 courses, until his doctors judged the disease unresponsive and progressing; supportive care followed. He survived 49 months after diagnosis. The article did not say whether this patient had been exposed to asbestos. It mentioned asbestos only as a known general risk factor, and the authors wrote that the link between peritoneal mesothelioma and asbestos is controversial. The authors concluded that earlier intervention may contribute to longer survival.

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 of a single patient, published as a letter to the editor
• Who was studied: One 74-year-old man seen in February 2008 by doctors at Sapporo Medical University, Japan, with a peritoneal mesothelioma that appeared to arise in the small bowel mesentery
• Exposure: The article does not report any asbestos exposure, occupation or exposure history for this patient. Asbestos (no fiber type named) and SV40 virus appear only as general risk factors in the discussion. There the authors state that the association of peritoneal mesothelioma with asbestos exposure is limited to a few cases and is controversial.
• Main results:
  • Exploratory surgery found small white nodules spread through the mesentery. Tissue examination gave a pathologic diagnosis of desmoplastic mesothelioma.
  • Soluble interleukin-2 receptor was slightly elevated (452 U/mL). The other tumor markers tested were within the normal range.
  • The tumor cells were positive for vimentin, smooth muscle actin and D2-40, and negative for calretinin, WT-1, desmin, CD34 and S-100. FISH analysis excluded a p16 deletion.
  • Combination chemotherapy based on irinotecan or gemcitabine with cisplatin was ineffective.
  • Cisplatin was then given into the abdomen (intraperitoneally) for 15 courses, until the doctors judged the disease unresponsive and progressing. The patient then received supportive care and survived 49 months after the initial diagnosis.
  • The authors stated that this was the first report of desmoplastic malignant mesothelioma of the peritoneum since the WHO defined the disease in 2004. Their literature review found only one previous report, published in 1982.
• The authors' conclusion: The authors concluded that earlier intervention may contribute to longer survival even in desmoplastic malignant mesothelioma. They also concluded that clinicians should consider malignant mesothelioma despite its rarity. They suggested that early diagnosis by exploratory surgery followed by combination chemotherapy may have contributed to this patient's longer survival compared with earlier reports.

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: Desmoplastic Mesothelioma, Malignant Mesothelioma, Peritoneum, Tumor Marker, Small Bowel Mesentery, Laparotomy, Mesentery, Histology.

Related studies

• 'Mucin-positive' epithelial mesothelioma of the peritoneum: an unusual diagnostic pitfall — D.S. Cook, R.L. Attanoos, et al. (2000)
• Primary epithelioid haemangioendothelioma of the peritoneum: an unusual mimic of diffuse malignant mesothelioma — R.L. Attanoos, N.S. Dallimore, et al. (1997)
• Malignant mesothelioma of the peritoneum: case reports and immunohistochemical findings including Ki-67 expression — H. Hirano, T. Fujisawa, et al. (2010)
• Malignant epithelial mesothelioma of the peritoneum: observations on a problem case — B.P. Eyden, S. Banik, et al. (1996)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases — A. Malpica, S. Sant'Ambrogio, et al. (2012)

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