Gray scale sonographic presentation of a mesothelioma of the greater omentum

Our plain-English summary of Gray scale sonographic presentation of a mesothelioma of the greater omentum, by J.M. Shah, D.L. King (Journal of Clinical Ultrasound, 1979).

The study

• Authors: J.M. Shah, D.L. King
• Journal: Journal of Clinical Ultrasound
• Published: 1979;7(2):147-8
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors, from the Division of Ultrasound at Columbia-Presbyterian Medical Center, New York, reported a case showing sonographic visualization of a mesothelioma of the greater omentum in an adult. A 32-year-old man presented with 6 weeks of increasing abdominal girth, decreased appetite, a 10-pound weight loss and diffuse abdominal pain. Abdominal x-ray showed ascites. Paracentesis yielded a bloody exudate, and cytology was negative for malignant cells. Ultrasonography showed ascites and an irregular lobulated solid mass (5 x 10 x 14 cm) adherent to the lower anterior abdominal wall. Arteriography showed neovascularity and tumor blush in omental branches. At exploratory laparotomy, 2 liters of peritoneal fluid were aspirated. Tumor masses studded the greater omentum and adjacent anterior parietal peritoneum but did not involve the visceral peritoneum. The pathologic diagnosis was papillary and tubular-type mesothelioma, and chemotherapy was begun. On further questioning, the patient said he had worked in a warehouse for 6 weeks 10 years earlier. He thought, though he was not certain, that he might have handled asbestos products. The authors concluded that the tumor was a primary omental mesothelioma, because its main blood supply came through the greater omental vessels and most of the tumor lay within the omentum. They noted that its echogenic pattern distinguished it from normal bowel but was otherwise nonspecific. Its location suggested a peritoneal or omental origin.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This case report described a 32-year-old man with six weeks of a swelling abdomen, poor appetite, a 10-pound weight loss and diffuse abdominal pain. Fluid had collected in his abdomen. It was bloody, and tests found no cancer cells in it. Ultrasound showed the fluid and an irregular, lumpy solid mass measuring 5 x 10 x 14 cm attached to the lower front abdominal wall. At surgery, tumor masses covered the greater omentum (a fatty apron of tissue inside the abdomen) and the nearby lining of the front abdominal wall, but not the lining of the organs. The diagnosis was papillary and tubular-type mesothelioma. When asked further, the man said he had worked in a warehouse for six weeks ten years earlier. He was not certain, but thought he might have handled asbestos products. The authors concluded the tumor began in the omentum, based on its blood supply and where most of it lay. They noted that its ultrasound pattern set it apart from normal bowel but did not reveal the tumor type.

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 32-year-old white man with abdominal swelling, weight loss and abdominal pain. The authors were in the Division of Ultrasound, Department of Radiology, Columbia-Presbyterian Medical Center, New York. The report was published in 1979.
• Exposure: Possible asbestos exposure: six weeks of warehouse work 10 years earlier, during which the patient thought, without being certain, that he might have handled asbestos products. No fiber type was given.
• Main results:
  • Fluid drawn from the abdomen was a bloody exudate, and cytology found no malignant cells.
  • Ultrasound showed ascites and an irregular lobulated solid mass, 5 x 10 x 14 cm, adherent to the lower anterior abdominal wall.
  • Angiography showed new vessel growth and tumor blush in multiple large omental artery branches.
  • At surgery, tumor masses studded the greater omentum and adjacent anterior parietal peritoneum. The tumor did not involve the visceral peritoneum.
  • Pathology diagnosed papillary and tubular-type mesothelioma. Chemotherapy was started after surgery.
• The authors' conclusion: The authors concluded the case was a primary omental mesothelioma. They based this on two points: the tumor's main blood supply came through the greater omental vessels, and at surgery most of the tumor appeared to lie within the omentum.
• Limitations the authors state:
  • The authors stated that the ultrasound echo pattern distinguished the tumor from normal bowel but was otherwise nonspecific, and that other tumor types may look similar.

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: Mesothelioma, Omentum, Ultrasound, Ascites, paracentesis, Exudate, Cytology, Laparotomy.

Related studies

• Primary malignant mesothelioma of the greater omentum: report of a case — Y.C. Liu, Y.L. Kuo, et al. (2004)
• Neoplastic and inflammatory processes of the peritoneum, omentum, and mesentery: diagnosis with CT — J.E. Hamrick-Turner, M.V. Chiechi, et al. (1992)
• Asbestos in extrapulmonary sites: omentum and mesentery — R.F. Dodson, M.F. O'Sullivan, et al. (2000)
• Mesothelial proliferation due to asbestos and man-made fibres. Experimental studies on rat omentum — J. Friemann, K.M. Müller, et al. (1990)
• Combined adenomatoid tumor and well differentiated papillary mesothelioma of the omentum — Y. Hatano, Y. Hirose, et al. (2011)
• Well-differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance — K.W.S. Ko, K.S. Tse, et al. (2018)

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