Dysphagia due to mesothelioma infiltrating the oesophagus: palliative treatment

Our plain-English summary of Dysphagia due to mesothelioma infiltrating the oesophagus: palliative treatment, by C.A. Lockwood, H.W. Jones, C.K. Foote, et al (Journal of the Royal Society of Medicine, 1989).

The study

• Authors: C.A. Lockwood, H.W. Jones, C.K. Foote, M.J. Turner
• Journal: Journal of the Royal Society of Medicine
• Published: 1989;82(3):168
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This was a case report of one patient. An 80-year-old Caucasian woman, a non-smoker with no history of occupational or environmental asbestos exposure, presented in November 1984 with increasing breathlessness and a right-sided pleural effusion. Pleural biopsies were first read as poorly differentiated adenocarcinoma; no primary tumour was found. Thirty-four months after presentation she reported a two-month history of increasing difficulty swallowing (dysphagia) and rapid weight loss of 12.5 kg. A barium swallow showed a 40 mm oesophageal stricture; endoscopy found a tumour completely blocking it. A guide wire could not be passed through the stricture, so a tube was placed in the oesophagus under general anaesthetic via a gastrotomy. Afterwards she improved quickly, went home, and gained 6 kg in 2 months on a liquidized diet. Oesophageal biopsies and immunohistochemical staining of earlier samples led to a diagnosis of mesothelioma invading the oesophagus. The authors called this the first reported case of invasive oesophageal mesothelioma diagnosed before death. The authors concluded that palliative treatment of dysphagia in mesothelioma is worthwhile, even with invasive disease. They also concluded mesothelioma should be considered when pleural biopsies suggest adenocarcinoma, especially with prolonged 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 (single patient)
• Who was studied: One 80-year-old Caucasian woman, a non-smoker, who presented in November 1984 with a right-sided pleural effusion; seen at Amersham General Hospital and Wycombe General Hospital, Bucks
• Exposure: No asbestos exposure was reported: the patient had no history of occupational or environmental exposure to asbestos
• Main results:
  • The patient's pleural biopsies were initially read as poorly differentiated adenocarcinoma, and no primary tumour was identified
  • Thirty-four months after presentation, the patient reported a 2-month history of increasing dysphagia and rapid weight loss of 12.5 kg
  • In this patient, a barium swallow showed a 40 mm long irregular stricture of the oesophagus at the level of the carina
  • A guide wire could not be passed through the patient's stricture
  • An endo-oesophageal tube was then placed in this patient under general anaesthetic via a gastrotomy
  • After tube placement the patient gained 6 kg in 2 months on a liquidized diet
  • On review of the histology, the patient's tumour cells were positive for epithelial membrane antigen and negative for carcinoembryonic antigen, and the diagnosis of mesothelioma invading the oesophagus was established
  • The authors stated this was the first case report of invasive mesothelioma of the oesophagus diagnosed before death
• The authors' conclusion: The authors concluded that palliative treatment of dysphagia associated with mesothelioma is worthwhile even in the presence of invasive disease. They also concluded that mesothelioma should be considered in patients with presumed anaplastic carcinoma or adenocarcinoma diagnosed on pleural biopsy, particularly when survival is prolonged.

Topics

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

Medical terms in this study, explained in our Lexicon: Dysphagia, Mesothelioma, Palliative Care.

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