Focal Peritoneal Mesothelioma Demonstrated on FDG PET/CT

Our plain-English summary of Focal Peritoneal Mesothelioma Demonstrated on FDG PET/CT, by J. Xiao, H. Yin, D. Cheng, et al (Clinical Nuclear Medicine, 2019).

The study

• Authors: J. Xiao, H. Yin, D. Cheng, H. Shi, Y. Xiu
• Journal: Clinical Nuclear Medicine
• Published: 2019;44(11):886-888
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 48-year-old woman was experiencing abdominal pain and melena for 3 months. Because of these symptoms combined with increased level of tumor marker CA125, possible abdominal malignancy was considered, and an FDG PET/CT was performed to assess occult tumor. The images revealed multiple hypermetabolic lesions along the peritoneal surface. Pathological examination after biopsy demonstrated low-grade epithelioid peritoneal mesothelioma.

In plain English

This is a short image-based case report about one patient. A 48-year-old woman had abdominal pain, diarrhea, nausea, vomiting and melena (black stools) for more than 3 months. Her blood level of the tumor marker cancer antigen-125 was 76.6 IU/mL, above the reference range of below 35 IU/mL. Earlier anatomical imaging had shown several focal lesions along the lining of the abdomen, suspected to be spread from a cancer elsewhere, so an FDG PET/CT scan was done to look for a primary tumor. The scan showed several spots of mildly increased activity in the abdomen, but no dominant activity that suggested a primary cancer. The most active spot was a lesion about 2.1 cm across in the capsule of the liver. No abdominal or pelvic lymph nodes were involved. A laparoscopic biopsy led to a diagnosis of primary malignant epithelioid peritoneal mesothelioma, with a proliferation index of 3%, which the authors read as slow growth. The authors concluded that this disease can appear as multiple small, distinct lesions on the liver capsule that FDG PET/CT can reveal. The article reports no asbestos or other exposure history for this patient.

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 'Interesting Image' article)
• Who was studied: One 48-year-old woman. The authors are from the Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China. The date of the case is not given.
• Exposure: The article does not report any asbestos or other exposure history for this patient.
• Main results:
  • The patient's cancer antigen-125 level was raised to 76.6 IU/mL (reference range below 35 IU/mL).
  • The PET scan showed multiple spots of mildly increased FDG activity in the abdomen, with no dominant activity suggesting a primary cancer.
  • The most intense activity (SUVmax 6.5) was in a lesion about 2.1 cm in diameter in the liver capsule, next to segment VII of the right lobe.
  • No lymph nodes in the abdomen or pelvis were involved.
  • Biopsy tissue had a proliferation index of 3%, which the authors took to mean the lesions were slow growing.
  • The pathology findings were reported as primary malignant epithelioid peritoneal mesothelioma.
• The authors' conclusion: The authors concluded that primary malignant peritoneal mesothelioma can present as multiple distinct small lesions on the liver capsule, which FDG PET/CT can reveal. They also said it should be considered when doctors evaluate lesions of the liver capsule.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Tumor Marker, Biopsy, Epithelioid.

Related studies

• 18F-FDG-PET/CT of peritoneal tumors: a pictorial essay — J. Dubreuil, F. Giammarile, et al. (2017)
• A Case of Localized Malignant Peritoneal Mesothelioma With Lung Cancer Detected by 18F-FDG PET/CT — S. Kobayashi Shimizu, T. Okamura, et al. (2020)
• The role of 18F-FDG-PET/ceCT in peritoneal mesothelioma — J. Dubreuil, F. Giammarile, et al. (2017)
• 18F-FDG Uptake of Localized Malignant Peritoneal Mesothelioma — E. Kodama, T. Kodama, et al. (2020)
• Whole-Body MRI: Comparison of Its Capability for TNM Staging of Malignant Pleural Mesothelioma With That of Coregistered PET/MRI, Integrated FDG PET/CT, and Conventional Imaging — Y. Ohno, M. Yui, et al. (2019)
• Present and future roles of FDG-PET/CT imaging in the management of malignant pleural mesothelioma — K. Kitajima, H. Doi, et al. (2016)

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