Giant fibrous pleural mesothelioma associated with myocardial restriction and hypoglycemia

Our plain-English summary of Giant fibrous pleural mesothelioma associated with myocardial restriction and hypoglycemia, by D.O. Kniznik, A.J. Roncoroni, M. Rosenberg, et al (Respiration; International Review of Thoracic Diseases, 1979).

The study

• Authors: D.O. Kniznik, A.J. Roncoroni, M. Rosenberg, G. Olmedo, H.J. Cohen
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 1979;37(6):346-51
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A giant pleural fibrous mesothelioma was the cause of severe nonobstructive ventilatory incapacity, myocardial restriction with congestive failure and hypoglycemic episodes in a 58-year-old man. Surgical resection resulted in complete recovery of respiratory function and disappearance of hypoglycemic episodes.

In plain English

This article was a case report of one patient: a 58-year-old man, seen at centers in Buenos Aires, who had a very large benign fibrous mesothelioma of the pleura (the lining around the lung). The article did not mention asbestos or any other exposure. Over some months he developed severe breathlessness on effort, swelling of both ankles, and episodes of heavy sweating and agitation that stopped after glucose was injected into a vein. His chest X-ray showed complete opacity on the left side. Breathing tests were greatly reduced (forced vital capacity 1.10, 34%). During one episode of confusion his blood sugar was 16 mg%, and his insulin levels were low. Surgeons removed an encapsulated tumor measuring 28 x 16 x 23 cm and weighing 4.9 kg. Afterwards his glucose tolerance and insulin levels returned to normal, and his heart pressure tracing became normal. His breathing capacity recovered only partially (forced vital capacity 2.20 liters, 60%). He remained in good health 16 months later. The authors described his low blood sugar as insulin-independent. They attributed his heart findings to compression by the rigid tumor.

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 58-year-old man, referred from another hospital to centers in Buenos Aires, Argentina (article received 1978, published 1979)
• Exposure: Not reported. The article does not mention asbestos or any other exposure.
• Main results:
  • The patient's chest X-ray on admission showed complete opacity of the left side, with the mediastinum pushed to the right.
  • Before surgery, the patient's forced vital capacity was 1.10 (34%) and his forced expiratory volume in 1 second was 0.90 liters (36%).
  • An episode of mental confusion in the patient coincided with a blood sugar of 16 mg%. A glucose tolerance test was accompanied by low blood insulin levels.
  • The surgically removed encapsulated tumor measured 28 x 16 x 23 cm and weighed 4.9 kg.
  • The pathology diagnosis was benign pleural fibrous mesothelioma.
  • After surgery, the patient's glucose tolerance returned to normal values with adequate insulin levels.
  • After surgery, the patient's ventilatory capacity recovered partially: forced vital capacity was 2.20 liters (60%).
  • After surgery, the patient's right ventricular pressure tracing had a normal contour.
  • The authors attributed the preoperative heart pressure pattern to compression of the right heart chambers by the rigid tumor.
  • The patient remained in good health 16 months after leaving hospital.
• The authors' conclusion: The authors concluded that the patient's falling insulin during low blood sugar showed that his low blood sugar was insulin-independent, with the body's normal glucose-insulin control preserved.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma, Surgical Resection.

Related studies

• Giant pleural mesothelioma associated with hypoglycemia and hyperthyroidism — G.J. Devroede, A.F. Tirol (1968)
• Solitary fibrous tumor of the pleura. An immunohistochemical, electron microscopic and tissue culture study of a tumor producing insulin-like growth factor I in a patient with hypoglycemia — E.H. Strøm, F. Skjørten, et al. (1991)
• Studies on the deposition of inhaled fibrous material in the respiratory tract of the rat and its subsequent clearance using radioactive tracer techniques. 1. UICC crocidolite asbestos — J.C. Evans, R.J. Evans, et al. (1973)
• Malignant mesothelioma associated with hypoglycemia; report of a case — K.A. Nesbitt, J.T. Boswell, et al. (1958)
• Causes and evaluation of tumor-induced hypoglycemia — S.C. Immerman, S.F. Sener, et al. (1982)
• Giant solitary fibrous tumor of the liver with metastasis to the skeletal system successfully treated with trisegmentectomy — S. Yilmaz, V. Kirimlioglu, et al. (2000)

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