Epithelial mesothelioma with deciduoid features: report of four cases

Our plain-English summary of Epithelial mesothelioma with deciduoid features: report of four cases, by N.G. Ordóñez (The American Journal of Surgical Pathology, 2000).

The study

• Author: N.G. Ordóñez
• Journal: The American Journal of Surgical Pathology
• Published: 2000;24(6):816-23
• Type of article: Case report
• Cited by: 38 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Deciduoid mesothelioma is the designation given to an unusual morphologic variant of epithelial mesothelioma that closely simulates exuberant ectopic decidual reaction. Because all four previously reported cases involved the peritoneum and occurred in young women without a history of asbestos exposure, it was suggested that deciduoid mesothelioma was a subtype of epithelial mesothelioma characterized by its unique morphology, that it affects a distinct patient population, and that it is unrelated etiologically to asbestos. The author reports four cases of mesothelioma with deciduoid features, all of which originated in the pleura. Three of the patients were men and one was a woman. Their ages ranged from 46 to 78 years (mean age, 67 yrs). Two of the patients had a history of asbestos exposure. These findings indicate that this morphologic variant of mesothelioma is not limited to a specific patient population nor is it restricted to the peritoneum.

In plain English

This article was a report of four cases of an unusual form of epithelial mesothelioma, called deciduoid mesothelioma, in which the tumor cells resemble decidual tissue. The author noted that the four cases published before had all involved the peritoneum in young women with no history of asbestos exposure, and that others had suggested the variant was unrelated to asbestos. The four new cases were found in a review of 320 mesothelioma cases at The University of Texas M.D. Anderson Cancer Center in Houston. All four tumors began in the pleura. Three patients were men and one was a woman, aged 46 to 78 years. Two of the men had a history of asbestos exposure; one was a building contractor described as having some exposure. The tumors behaved aggressively, with a reported mean survival of 6.3 months; survival was not available for one patient. The tumor cells stained positive for markers used to identify mesothelioma. The author concluded that this variant is not limited to women or to the peritoneum, and that patients may or may not have a history of asbestos exposure.

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 series (report of four cases) with pathology, immunohistochemistry and electron microscopy
• Who was studied: Four patients with pleural mesothelioma with deciduoid features (3 men, 1 woman, aged 46 to 78 years), identified from 320 mesothelioma cases in the pathology files of The University of Texas M.D. Anderson Cancer Center, Houston, TX. For the three patients whose dates are given, the disease was diagnosed between 1979 and 1989.
• Exposure: Two of the four patients had a history of asbestos exposure: a 64-year-old building contractor with some asbestos exposure, and a 78-year-old man with a history of asbestos exposure. No fiber types or doses were given. The other two patients (a school teacher and a 60-year-old man) had no history of asbestos exposure.
• Main results:
  • In all four patients the tumor originated in the pleura.
  • Three of the four patients were men, two of whom had a history of asbestos exposure.
  • The tumors behaved in a highly aggressive manner. Mean survival in this series was 6.3 months, which the author called comparable to the mean of 7.3 months in previously reported patients. Survival was not available for patient 4.
  • All cases tested for the positive mesothelioma markers (calretinin, cytokeratin 5/6, thrombomodulin) were positive. None of the four stained with MOC-31.
• The authors' conclusion: The author concluded that epithelial mesothelioma with deciduoid features is not limited to women or restricted to the peritoneum, can occur in pure form or with areas of more conventional appearance, and that patients may or may not have a history of asbestos exposure.

Topics

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

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

Related studies

• Deciduoid or pseudodecidual mesothelioma — A. Talerman (2000)
• An Autopsy Case Report of Malignant Pleural Mesothelioma with Deciduoid Features — R. Ushio, M. Yamamoto, et al. (2015)
• A biphasic tumor of the mediastinum with features of synovial sarcoma. A report of four cases — G.B. Witkin, M. Miettinen, et al. (1989)
• Dedifferentiated Liposarcoma With Epithelioid/Epithelial Features — N. Makise, A. Yoshida, et al. (2017)
• Mesotheliomas with deciduoid morphology: a morphologic spectrum and a variant not confined to young females — J.H. Shanks, M. Harris, et al. (2000)
• Primary Malignant Deciduoid Mesothelioma: A Challenging Diagnosis — M. Regragui, N.B. Guebessi (2019)

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