Giant benign mesothelioma

Our plain-English summary of Giant benign mesothelioma, by D.M. Watts, G.P. Jones, G.A. Bowman, et al (The Annals of Thoracic Surgery, 1989).

The study

• Authors: D.M. Watts, G.P. Jones, G.A. Bowman, J.D. Olsen
• Journal: The Annals of Thoracic Surgery
• Published: 1989;48(4):590-1
• Type of article: Case report
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pleural mesothelioma is a rare neoplasm that is usually highly malignant, but benign mesotheliomas do occur; approximately 400 cases are described in the literature. We report the case of a young woman with a massive benign mesothelioma that filled the entire left hemithorax but was successfully resected with full reexpansion of the lung.

In plain English

This case report described a 20-year-old Polynesian woman from the Marshall Islands with about a year of shortness of breath on exertion and left-sided chest pain. Tuberculosis drugs, started after a positive skin test, did not help, and she was referred to the authors' hospital. Scans showed a mass filling the left side of her chest, pressing on the windpipe and heart, and her left lung had collapsed. Surgeons removed the tumor, which grew on a 5-cm stalk from the lining of the chest wall (parietal pleura), along with part of four ribs. It measured 21 x 16 x 9 cm and weighed 1,460 g. The lung fully re-expanded, and she was discharged on the fourteenth day after surgery. The diagnosis was benign localized fibrous mesothelioma. The article did not say whether she had any asbestos exposure. Citing earlier work, the authors wrote that benign mesothelioma appears unrelated to asbestos exposure. The authors concluded that such tumors require aggressive initial surgery and periodic long-term follow-up.

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
• Who was studied: One patient: a 20-year-old Polynesian woman from the island of Maduro in the Marshall Islands, treated at Tripler Army Medical Center, Hawaii
• Exposure: The article does not report whether the patient had any asbestos exposure. Citing earlier work, the authors wrote that, unlike malignant mesothelioma, benign mesothelioma appears to be unrelated to asbestos exposure.
• Main results:
  • Before referral, the patient was started on tuberculosis drugs after a positive skin test, and she did not improve.
  • Imaging showed a mass filling the entire left side of the chest, with marked compression of the trachea, heart and other mediastinal structures.
  • Breathing tests showed a severe restrictive defect in the patient, with a vital capacity of only 990 cm3.
  • At surgery, the tumor arose from the posterior parietal pleura on a wide-based 5-cm pedicle (stalk) extending from the second to the fifth ribs. It was removed completely, together with a 6 x 6-cm segment of ribs two through five.
  • The removed mass measured 21 x 16 x 9 cm and weighed 1,460 g.
  • After the tumor was removed, the patient's left lung fully re-expanded. She tolerated the operation well and was discharged on the fourteenth day after surgery.
  • The pathological diagnosis was benign localized fibrous mesothelioma.
• The authors' conclusion: The authors concluded that these tumors call for aggressive initial surgical excision and periodic long-term follow-up.

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, Pleural Mesothelioma, Neoplasm, Hemithorax.

Related studies

• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)
• A case of giant benign localized fibrous tumor of the pleura — M. Biçer, S. Yaldiz, et al. (1998)
• Giant benign fibrous tumor of the pleura in a pregnant woman: report of a case — A. Cakan, U. Cagirici, et al. (2003)
• Giant solitary fibrous tumor of the liver with metastasis to the skeletal system successfully treated with trisegmentectomy — S. Yilmaz, V. Kirimlioglu, et al. (2000)
• Alveolar macrophage kinetics and multinucleated giant cell formation after lung injury — H. Prieditis, I.Y. Adamson (1996)
• Giant Pediatric Rhabdoid Meningioma Associated with a Germline BAP1 Pathogenic Variation: A Rare Clinical Case — A.C. Ravanpay, A. Barkley, et al. (2018)

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