Distant visceral metastases in pleural mesothelioma

Our plain-English summary of Distant visceral metastases in pleural mesothelioma, by G.H. Roberts (British Journal of Diseases of the Chest, 1976).

The study

• Author: G.H. Roberts
• Journal: British Journal of Diseases of the Chest
• Published: 1976;70(4):246-50
• Cited by: 82 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003704).

Abstract

Distant visceral metastases were found in 15 of 32 cases of pleural mesothelioma (47%). Contrary to earlier reports pleural mesothelioma should be regarded as a tumour in which visceral metastases are not uncommon. No association was found between the histological type of mesothelioma and visceral metastases; the peritoneal involvement found in five cases is probably due to local infiltration and seeding.

In plain English

This was an autopsy study from the pathology department of the Southern General Hospital, Glasgow, of 32 cases of pleural mesothelioma. Each case was confirmed under the microscope after a post-mortem examination. The article did not report the patients' asbestos exposure. Tumour had spread to distant organs in 15 of the 32 cases (47%), and to lymph glands in the centre of the chest in 17 (53%). The commonest distant site was the opposite lung (seven cases), followed by the kidneys (five) and the adrenal glands (three). The heart and brain were each involved in two cases. Distant spread occurred with all three tumour types: 7 of 14 epithelial, 5 of 10 mixed and 3 of 8 mesenchymal. Tumour was found in the peritoneal (abdominal) cavity in five cases (16%), which the author considered probably due to local spread and seeding. For comparison, 70 of 100 consecutive autopsied cases of bronchial carcinoma had distant metastases. The author concluded that, contrary to earlier reports, distant visceral metastases are not uncommon in pleural mesothelioma.

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: Autopsy (necropsy) case series of pleural mesothelioma, compared with necropsy reports of bronchial carcinoma
• Who was studied: 32 cases of pleural mesothelioma examined at necropsy at the Southern General Hospital, Glasgow (dates not given). By tumour type: 10 mixed, 14 epithelial and 8 mesenchymal. The comparison group was 100 consecutive necropsy cases of bronchial carcinoma.
• Exposure: Not reported. The article does not describe the patients' asbestos or other exposures; it studies where the tumour had spread at death.
• Main results:
  • Among the 32 pleural mesothelioma cases, distant visceral metastases were found in 15 (47%), and tumour in the hilar and mediastinal lymph glands in 17 (53%).
  • In the mesothelioma cases, the commonest distant site was the opposite lung (7 cases), followed by the kidneys (5 cases, both kidneys in 4).
  • In the mesothelioma cases, the heart and the brain were each involved in two cases.
  • Visceral metastases by tumour type: 7 of 14 epithelial, 5 of 10 mixed and 3 of 8 mesenchymal mesotheliomas.
  • Tumour was found in the peritoneal cavity in 5 of the 32 mesothelioma cases (16%).
  • Of the five mesotheliomas with peritoneal involvement, two were of mixed type, two mesenchymal and one epithelial.
  • None of the 12 patients with left-sided pleural mesothelioma had tumour in the peritoneal cavity.
  • In the comparison group of 100 consecutive bronchial carcinoma necropsies, distant visceral metastases were present in 70%.
  • Within the bronchial carcinoma group, metastases were found in 50 of 60 oat cell and undifferentiated carcinomas (83%) and in 20 of 40 squamous and adenocarcinomas (50%).
• The authors' conclusion: The author concluded that, contrary to earlier reports, pleural mesothelioma should be regarded as a tumour in which visceral metastases are not uncommon. The author found no association between histological type and visceral metastases, and considered the peritoneal involvement in five cases probably due to local infiltration and seeding.
• Limitations the authors state:
  • In a few of the earlier cases the brain was not examined at necropsy.
  • The author was uncertain whether the peritoneal tumour in five cases was distant spread, local infiltration, or tumour arising in more than one place.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma.

Related studies

• An autopsy case of serous papillary carcinoma of peritoneum with distant metastases but no peritoneal dissemination — O. Miyaishi, K. Iida, et al. (1994)
• Metastases in diffuse pleural mesothelioma: influence of histological type — M. Huncharek, J. Muscat (1987)
• Spontaneous pneumothorax and pulmonary malignant disease--a syndrome sometimes associated with cavitating tumours. Report of nine new cases, four with metastases and five with primary bronchial tumours — F.W. Wright (1976)
• Peritoneal malignant mesothelioma with multiple distant skin metastases — N.G. Ordóñez, J.L. Smith (1983)
• Multiple distant metastases in a case of malignant pleural mesothelioma — K.C. Tertemiz, A. Ozgen Alpaydin, et al. (2014)
• Metastases — P. Zeppa, I. Cozzolino (2018)

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