Extraskeletal myxoid chondrosarcoma of the pleura. Report of a case clinically simulating mesothelioma

Our plain-English summary of Extraskeletal myxoid chondrosarcoma of the pleura. Report of a case clinically simulating mesothelioma, by S.P. Goetz, R.A. Robinson, S.K. Landas (American Journal of Clinical Pathology, 1992).

The study

• Authors: S.P. Goetz, R.A. Robinson, S.K. Landas
• Journal: American Journal of Clinical Pathology
• Published: 1992;97(4):498-502
• Type of article: Case report
• Cited by: 27 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A primary extraskeletal myxoid chondrosarcoma of the pleura that clinically mimicked a malignant mesothelioma in a 66-year-old man with a history of asbestos exposure is described. Although exceedingly rare in this location, the characteristic histologic features, immunohistochemical reactivities, and ultrastructural features support the diagnosis of extraskeletal myxoid chondrosarcoma. Many ferruginous (asbestos) bodies consistent with the exposure history were found in the lung tissue sections and confirmed by energy-dispersive spectrometry. This case demonstrates an unusual pleural primary neoplasm associated with asbestos.

In plain English

This article was a single case report from pathologists at the University of Iowa Hospitals and Clinics. It described a 66-year-old man admitted to the Department of Veteran's Affairs Medical Center in Iowa City, Iowa. The patient had a 15-year occupational history of asbestos exposure from working with furnaces. A chest x-ray and CT scan showed a large pleural-based tumor encasing the right lung, which suggested malignant mesothelioma. The authors instead diagnosed the biopsy tissue as extraskeletal myxoid chondrosarcoma, a rare soft-tissue cancer. They based this on its appearance under the microscope, special stains and electron microscopy, and found no distant primary tumor. Two stains (S-100 and Leu 7) could not be interpreted because control tissue also failed to stain. The lung tissue contained many ferruginous (asbestos) bodies, and elemental analysis was consistent with chrysotile. The patient refused further therapy. The authors reported this as, to their knowledge, the first case of this tumor arising in the pleura found with asbestos exposure. They noted that the two might occur together by coincidence.

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 66-year-old man admitted to the Department of Veteran's Affairs Medical Center of Iowa City, Iowa; the pathology was done at the University of Iowa Hospitals and Clinics
• Exposure: 15-year occupational asbestos exposure from working with furnaces. Asbestos bodies and elemental analysis of the lung tissue were consistent with chrysotile
• Main results:
  • Chest x-ray and CT showed a large pleural-based tumor encasing the right lung and extending into the major fissure, suggesting malignant mesothelioma
  • Under the microscope the tumor showed features characteristic of myxoid chondrosarcoma
  • Electron microscopy showed microtubule aggregates within rough endoplasmic reticulum, described as a diagnostic feature of extraskeletal myxoid chondrosarcoma
  • Immunostaining showed only vimentin. S-100 and Leu 7 were negative, but internal control tissue also failed to stain
  • Careful clinical evaluation found no distant primary tumor
  • Lung tissue contained many ferruginous bodies, and energy-dispersive spectrometry showed magnesium and silicon in a proportion consistent with chrysotile
  • The authors stated that, to their knowledge, this was the first reported case of primary extraskeletal myxoid chondrosarcoma of the pleura found with asbestos exposure
  • The patient refused further therapy
• The authors' conclusion: The authors concluded that the case shows an unusual primary pleural tumor associated with asbestos. They noted that an association between asbestos and this tumor had not been described, and that the two being present together in this case may be coincidental
• Limitations the authors state:
  • The negative S-100 and Leu 7 results were invalid because the internal controls failed to stain
  • The asbestos exposure and the tumor being present together may be coincidental

Topics

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

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

Related studies

• Extraskeletal osteosarcoma of the pleura:report of a case — H. Shiota, T. Yasukawa, et al. (2013)
• Extrapleural pneumonectomy for sarcomas report of two cases — A.V. Bedini, L. Tavecchio, et al. (2000)
• Primary myxoid sarcoma of the pleura: 5 years follow-up — R. Tosson, M. Krismann (2000)
• Malignant mesothelioma with a pronounced myxoid stroma: a clinical and pathological evaluation of 19 cases — J. Shia, J. Qin, et al. (2005)
• Thymidylate synthase and folyl-polyglutamate synthase are not clinically useful markers of response to pemetrexed in patients with malignant pleural mesothelioma — D.E. Lustgarten, C. Deshpande, et al. (2013)
• Pseudomesotheliomatous angiosarcoma: a pleuropulmonary lesion simulating malignant pleural mesothelioma — G. Falconieri, R. Bussani, et al. (1997)

Browse more research in American Journal of Clinical Pathology, or return to medical research.