Diffuse malignant peritoneal mesothelioma presenting as small bowel obstruction

Our plain-English summary of Diffuse malignant peritoneal mesothelioma presenting as small bowel obstruction, by A.R. Tagliaferri, G. Melki, A. Rezkalla, et al (Radiology Case Reports, 2023).

The study

• Authors: A.R. Tagliaferri, G. Melki, A. Rezkalla, W. Baddoura
• Journal: Radiology Case Reports
• Published: 2023;18(8):2681-2684
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Mesotheliomas are aggressive malignant tumors which can occur most commonly in the pleural space, however can occur in the peritoneum in those with an extensive history of asbestos exposure. Primary peritoneal mesothelioma is relatively rare and is a fatal diagnosis. The prognosis of primary peritoneal mesothelioma is very poor and individuals are at high risk of developing mesothelioma in another cavity within the first year after initial diagnosis. Herein, we present a case of primary peritoneal mesothelioma, presenting as small bowel obstruction.

© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.

In plain English

This article was a case report about one patient. He was an 81-year-old man who reported working for many years in a factory that made wire hangers, and who thought he had inhaled asbestos-containing metal particles there. The report did not name a fiber type or measure his exposure. He first went to the emergency department when his diarrhea began and was diagnosed with gastroenteritis. About 3 weeks later he returned with worsening nausea, vomiting and abdominal swelling. A new CT scan suggested small bowel obstruction. During surgery, bowel that was removed was found to contain diffuse malignant peritoneal mesothelioma of the epithelioid type. He then received the immunotherapy drugs nivolumab and ipilimumab. About 2 years after diagnosis he was moved to hospice because of increased tumor burden, despite palliative radiation and adjunctive chemotherapy. The authors concluded that he outlived his life expectancy given his age, gender, tumor location, cause and tissue subtype. Because this is a single case, it describes what happened to one person, not how often the disease occurs.

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
• Who was studied: One 81-year-old Arabic man treated at St. Joseph's University Medical Center, Paterson, New Jersey, USA
• Exposure: Self-reported: many years as a factory worker making wire hangers, where he thought he inhaled asbestos-containing metal particles; no fiber type or dose given
• Main results:
  • At his first emergency visit, at the onset of diarrhea, the patient was diagnosed with gastroenteritis
  • When he came back, he had worsening nausea, vomiting and abdominal distention
  • A repeat CT scan suggested small bowel obstruction
  • Pathology of the removed bowel showed diffuse peritoneal malignant mesothelioma, epithelioid type
  • The tumor stained strongly positive for calretinin, CK 5/6, WT-1 and D2-40
  • A PET-CT one month after discharge showed a peritoneal finding suspicious for malignancy but no metastatic disease
  • He received 12 cycles of nivolumab 3 mg/kg every 3 weeks, plus 7 cycles of ipilimumab every 6 weeks
  • He was transferred to hospice about 2 years after initial diagnosis because of increased tumor burden
• The authors' conclusion: The authors concluded that the patient outlived his life expectancy given his age, gender, tumor location, cause and histological subtype

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelioma, Peritoneum, Asbestos Exposure, Prognosis.

Related studies

• Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature — S.C. Frontario, A. Loveitt, et al. (2015)
• Diffuse malignant peritoneal mesothelioma presenting as intestinal obstruction — J. Griniatsos, S. Sougioultzis, et al. (2009)
• Peritoneal metastases from small bowel cancer: Results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in The Netherlands — T.R. van Oudheusden, V.E. Lemmens, et al. (2015)
• "Signet-ring" cells--a caveat in the diagnosis of a diffuse peritoneal mesothelioma occurring in a lady presenting with recurrent ascites: an unusual case report — B. Rekhi, S. Pathuthara, et al. (2010)
• Diffuse Malignant Peritoneal Mesothelioma Presenting with Psammomatous Calcification on a Cervical Smear — A. Tan, P. Cohen, et al. (2015)
• Mucin-positive epithelial mesothelioma of the peritoneum: small bowel involvement — J.H. Kim, K.Y. Kwon, et al. (2011)

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