Epithelioid malignant mesothelioma presenting with features of esophageal tumor

Our plain-English summary of Epithelioid malignant mesothelioma presenting with features of esophageal tumor, by M.W. Khalil, A.P. Campbell, M.E. Cowen (Asian Cardiovascular & Thoracic Annals, 2011).

The study

• Authors: M.W. Khalil, A.P. Campbell, M.E. Cowen
• Journal: Asian Cardiovascular & Thoracic Annals
• Published: 2011;19(3-4):260-1
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Intrathoracic epithelioid mesothelioma commonly presents as a diffuse tumor of the pleura. It rarely occurs as a localized tumor that might be surgically resectable. We report a case of one such localized mesothelioma in a 72-year-old woman, which arose from the wall of the esophagus and had all the presenting features of an esophageal tumor.

In plain English

This is a case report of one patient treated at a UK hospital. A 72-year-old Caucasian woman had six months of intermittent difficulty swallowing. A CT scan showed a mass in the posterior mediastinum (the back of the chest) measuring up to 8.5 cm across, pressing on and distorting the esophagus (food pipe). CT findings were consistent with an esophageal duplication cyst, leiomyoma, or gastrointestinal stromal tumor. Endoscopic ultrasound suggested most likely a leiomyoma or gastrointestinal stromal tumor with malignant change. The authors reported no occupational history suggestive of asbestos exposure. Surgeons removed the 272-gram mass through the right side of the chest. It appeared to arise within the muscle wall of the esophagus and to have invaded the pericardium (the sac around the heart) at one point, so a small piece of pericardium was removed with it. The patient was discharged 11 days later. Tissue examination, including antibody staining, was consistent with epithelioid malignant mesothelioma, and similar tumor tissue was found in the pericardium. The authors concluded that such tumors should not be declared benign before histology results are available, even if they look completely removable.

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 72-year-old Caucasian woman with a 6-month history of intermittent dysphagia (difficulty swallowing), treated in the authors' cardiothoracic surgery unit (Castle Hill Hospital, Cottingham, UK); dates not given
• Exposure: No asbestos exposure was identified; the authors report no occupational history suggestive of asbestos exposure
• Main results:
  • CT scan showed a posterior mediastinal mass up to 8.5 cm in diameter abutting and distorting the esophagus
  • The CT appearance was thought consistent with an esophageal duplication cyst, esophageal leiomyoma, or gastrointestinal stromal tumor
  • Endoscopic ultrasound showed the appearance of a submucosal lesion of the esophagus, most likely a leiomyoma or gastrointestinal stromal tumor with malignant change
  • At right thoracotomy the mass appeared to arise from within the muscle wall of the esophagus
  • The mass appeared to have invaded the pericardium at one point and was excised together with a small piece of pericardium; it weighed 272 grams
  • The patient did well after surgery and was discharged 11 days later
  • Histology and immunohistochemistry (positive for pan cytokeratin, calretinin, cytokeratin 5/6 and thrombomodulin; negative for carcinoembryonic antigen, Ber EP4 and AUA-1) were consistent with epithelioid malignant mesothelioma, not the expected leiomyoma or gastrointestinal stromal tumor
  • Similar tumor tissue was found in the pericardium removed with the mass
• The authors' conclusion: The authors concluded that localized mediastinal tumors that are circumscribed at surgery and appear completely resectable should not be declared benign before histology results are available, and that a diagnosis of epithelioid malignant mesothelioma in such a case should not be met with excessive skepticism.

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: Epithelioid, Malignant Mesothelioma, Intrathoracic, Mesothelioma, Pleura, Localized Malignant Mesothelioma.

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