Case Reports in Oncology

Our medical research library holds 17 studies published in Case Reports in Oncology (2009–2026). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 17 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Karger
• Published: 2008 to the present, Switzerland
• Language: English
• ISSN: 1662-6575 (electronic)
• Its record in the NLM Catalog

2020s

• Malignant Mesothelioma Extending from Peritoneum to Pleura: A Diagnostic Challenge and Case Report. T.T. Phan, T.Q.H. Pham, V.D. Le, et al. 2026;19(1):785-795. Case report PubMed · Publisher · Free full text

  Abstract

  Introduction: Sarcomatoid malignant peritoneal mesothelioma (SM-MPM) is an exceptionally rare and aggressive subtype of peritoneal mesothelioma, often presenting with nonspecific symptoms such as ascites. Due to its subtle clinical manifestations, diagnosis is frequently delayed, resulting in poor prognosis. Early and accurate identification is crucial for guiding appropriate therapeutic strategies.

  Case Presentation: We report the case of a 52-year-old woman with no history of smoking, alcohol use, or asbestos exposure, who previously underwent subtotal hysterectomy for uterine fibroids in 2017. Ten months prior to admission, she developed progressive abdominal distension, fatigue, and ascites, accompanied by elevated CA-125 levels. Initial symptomatic improvement was achieved with diuretics, but no definitive diagnosis was established. Eight months later, she was readmitted with recurrent ascites, chest tightness, and dyspnea. Imaging revealed right pleural effusion, pneumothorax, and peritoneal thickening. Pleuroscopic biopsy showed reactive mesothelial proliferation. One month into hospitalization, rapid re-accumulation of ascitic fluid prompted repeat imaging, which demonstrated irregular peritoneal thickening and nodularity. Laparoscopic peritoneal biopsy with immunohistochemistry confirmed the diagnosis of SM-MPM. The disease was staged as T3N0M1 based on the Peritoneal Cancer Index (PCI), indicating advanced disease with poor prognosis. The patient was referred to a specialized oncology center for further management.

  Conclusions: This case underscores the diagnostic challenges of SM-MPM, particularly in patients presenting with recurrent unexplained ascites and multiple serous effusions. It highlights the importance of maintaining a high index of suspicion and the pivotal role of laparoscopy, immunohistochemistry, and multidisciplinary collaboration in achieving timely diagnosis and optimizing patient outcomes.

  © 2026 The Author(s). Published by S. Karger AG, Basel.

• Successful Response to First-Line Carboplatin, Pemetrexed, and Bevacizumab for Peritoneal Mesothelioma: Two Case Reports. T. Koizumi, S. Kanda, N. Sekiguchi, et al. 2025;18(1):278-285. Case report PubMed · Publisher · Free full text

  Abstract

  Introduction: Peritoneal mesothelioma is an extremely rare malignancy of the peritoneum. It has a poor prognosis, and the optimal systemic chemotherapy remains controversial. Here, we report two cases of peritoneal mesothelioma with long-term survival and complete response to carboplatin, pemetrexed, and bevacizumab chemotherapy.

  Case Presentation: Both patients were treated with six cycles of carboplatin (AUC 5), pemetrexed (750 mg/m2), and bevacizumab (15 mg/kg) followed by pemetrexed and bevacizumab as maintenance therapy. Partial response continued for over 6 years in case 1, and complete response was obtained in case 2. The patient in case 1 died after 7 years due to accidental pneumonia, and the patient in case 2 remained disease-free for over 2 years after initiation of chemotherapy.

  Conclusion: Little information is available regarding angiogenesis in malignant peritoneal mesothelioma, and carboplatin/pemetrexed/bevacizumab are off-labeled chemotherapy by Japanese healthcare system as yet. However, our experience suggested that combined chemotherapy with bevacizumab is a feasible option for systemic chemotherapy in cases of peritoneal mesothelioma.

  © 2025 The Author(s). Published by S. Karger AG, Basel.

• Primary Peritoneal Mesothelioma Affecting the Greater Omentum That Mimicked an Omental Infarction: A Case Report. J.C. Cravero, T. Yakubik, L. Wahab, et al. 2024;17(1):596-601. Case report PubMed · Publisher · Free full text

  Abstract

  Introduction: Malignant peritoneal mesothelioma (MPM) is a rare cancer that is associated with asbestos exposure. The diagnosis can be difficult given the nonspecific nature of presenting symptoms and the presence of concomitant confounding findings.

  Case Presentation: We report a 71-year-old male who presented with right lower quadrant pain and new-onset ascites. CT imaging of the abdomen/pelvis demonstrated omental stranding concerning for a possible omental infarction. Subsequent imaging showed persistent omental edema but no identifiable soft tissue mass. A biopsy of the omentum showed atypical mesothelial proliferation, but pathology was unable to determine if proliferation was a neoplastic versus reactive process. Surgical oncology performed a diagnostic laparoscopy that showed peritoneal studding of the omentum. Subsequent immunohistochemical staining of the omentum demonstrated preservation of BAP1 expression and loss of MTAP expression, consistent with peritoneal mesothelioma.

  Conclusion: MPM is a rare and aggressive cancer with an overall poor prognosis. The diagnosis of MPM can be difficult based on the nonspecific clinical presentation, insufficient imaging and laboratory testing, and the presence of concomitant confounding findings, such as with this patient and his admitting diagnosis of omental infarction. This case demonstrates the importance of developing a broad differential while maintaining an awareness of heuristics that can influence clinical decision-making.

  © 2024 The Author(s). Published by S. Karger AG, Basel.

• Malignant Mesothelioma of the Testes with Retroperitoneal Recurrence and Resection in an 80-Year-Old Male and Review of the Literature. W.C.I. Janes, S. Al-Asaaed, P.H. Johnston. 2023;16(1):698-704. Case report PubMed · Publisher · Free full text

  Abstract

  Malignant mesothelioma of the testes is an aggressive, yet rare urogenital malignancy, accounting for an infinitesimally small number of oncologic diagnoses. This infrequent occurrence is accompanied by a relative lack of knowledge surrounding this disease, thus limiting management options beyond surgical intervention. Oftentimes, these malignancies present with a poor prognosis despite early intervention and only worsen in the event of metastatic spread with poor survival and limited response to treatment, if any. Our case documents positive patient outcomes following the use of aggressive surgical intervention in the management of a metastatic testicular mesothelioma. A healthy 80-year-old male with sudden painless testicular swelling requiring radical orchidectomy following failed initial conservative management. Pathologically, the specimen was diagnosed as malignant mesothelioma of the right testis with involvement of the tunica albuginea and tunica vaginalis. Following disease recurrence at 82 years of age, the patient subsequently opted for an open right-sided template non-nerve sparing retroperitoneal lymph node dissection which was undertaken without complication. Malignant mesothelioma of the testes remains an ominous diagnosis with historically poor outcomes and for which surgical intervention remains the mainstay of treatment. The retroperitoneal lymphatic drainage represents the most common route of metastatic spread for testicular tumours; however, retroperitoneal lymph node dissection has rarely been employed in this patient population and never in an individual of this age. Our findings contribute to the growing literature surrounding these rare malignancies and outline the importance of considering both patient autonomy and the clinical picture in disease management.

  © 2023 The Author(s). Published by S. Karger AG, Basel.

• Diffuse Peritoneal Malignant Mesothelioma Presenting with Abnormal Uterine Bleeding: Case Report. I. Rizzuto, T. Power, M.K. Oehler. 2022;15(1):251-256. Case report PubMed · Publisher · Free full text

  Abstract

  This report describes a highly unusual case of malignant peritoneal mesothelioma (MPM), who presented with abnormal menstrual bleeding due to diffuse infiltration of the uterus. MPM is a rare entity, which on initial clinical presentation can be indistinguishable from a primary gynecological malignancy such as ovarian cancer. As differential diagnosis is challenging among primary care physicians, gynecologists, gynecological oncologists, and pathologists, misdiagnosis and subsequent mismanagement are not uncommon. Immunohistochemical stains were required in our case to help to make the final diagnosis. We included multiple mesothelial markers such as calretinin, CK5/6, WT-1, and D240 in our analysis, in addition to epithelial markers such as Claudin-4, BerEP4, B72.3, and PAX-8, to exclude metastatic adenocarcinoma.

  Copyright © 2022 by S. Karger AG, Basel.

• Mesothelioma: A Case in a Diagnostic Timeline and the Efficiency of Robot-Assisted Surgery. P. Zarogoulidis, K. Tsakiridis, T. Zarampoukas, et al. 2022;15(1):149-155. Case report PubMed · Publisher · Free full text

  Abstract

  We present a case of a 65-year-old male with a difficulty to diagnose mesothelioma. To be specific, three attempts were made to diagnose the disease, and only with a large sample performed with robot-assisted surgery, our pathologists were able to identify the malignancy. The novelty for our case is mostly based on the timeline of the diagnosis along with the tissue samples where we present the course of the transformation from benign to malignancy. All tissue biopsies were checked by two independent pathologists. Conclusively, diagnosis for small local lesions should be performed with an endoscopic method, video-assisted or robot-assisted.

  Copyright © 2022 by S. Karger AG, Basel.

• Unusually Aggressive Presentation of Malignant Peritoneal Mesothelioma: Two Case Reports. D. Neff, B.C. Padberg Sgier, H. Dietze, et al. 2022;15(3):1001-1008. Case report PubMed · Publisher · Free full text

  Abstract

  Malignant peritoneal mesothelioma is a rare disease. Patients mainly present with abdominal distension, pain, nausea, and weight loss with or without an exposure history of asbestos. Diagnosis may be difficult from a clinical and histopathologic perspective. Treatment options are surgery in early stages, radiotherapy and/or intraperitoneal or systemic therapy. Prognosis depends on TNM stage and histologic subtype with epithelioid subtype being the most favorable one but in general remains poor. We present a 59-year-old male (patient 1) and a 79-year-old female (patient 2) with progressive dyspnea. PET-CT of patient 1 revealed metastatic spread in the pleura and extensive peritoneal carcinomatosis. PET-CT of patient 2 displayed FDG-avid lymph nodes on both sides of the diaphragm, polyserositis, and FDG uptake along the peritoneum. Both patients were eventually diagnosed with malignant peritoneal mesothelioma. Patient 1 was treated with carboplatin and gemcitabine, and patient 2 received no systemic therapy. Even though the epithelioid subtype was found, both patients succumbed due to rapid tumor progression in a matter of a few weeks only. Presentation with polyserositis even in the absence of relevant asbestos exposure may represent malignant peritoneal mesothelioma if ascites is present, and rapid invasive diagnostic (excision biopsy) should be performed. These two unusual cases emphasize that even in epithelioid subtype, clinicians ought to be aware of possible rapid clinical deterioration, and timely diagnosis with initiation of therapy is crucial. Further research is necessary to better understand tumor biology, establish predictive markers, and develop new treatment options.

  Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel.

• Pregabalin Attenuates Carboplatin-Induced Akathisia-Like Neuropathy: A Novel Case Report. Y. Saito, Y. Takekuma, M. Furuta, et al. 2021;14(3):1418-1421. Case report PubMed · Publisher · Free full text

  Abstract

  Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most serious adverse effects of chemotherapy. We experienced carboplatin (CBDCA)-induced akathisia-like CIPN, which was significantly attenuated by pregabalin administration, and report its treatment. A man in his 40s was administered CBDCA + pemetrexed (PEM) as the third-line treatment for recurrent malignant pleural mesothelioma. He rarely experienced mild akathisia-like symptoms on his feet before the diagnosis. The patient claimed that he exhibited mild degradation of the symptoms in the previous cisplatin (CDDP) + PEM treatment without the need for pharmacotherapy. Symptoms notably worsened approximately 7 days after the first cycle of CBDCA + PEM and did not disappear. Furthermore, symptoms worsened during the daytime and became milder at night. Lorazepam (0.5 mg) was administered 3 times a day from day 14 but was not effective. Finally, we evaluated the symptoms to be derived from CBDCA-induced neuropathy as he experienced the same symptoms in CDDP + PEM and did not have suspicious pathology or medicines for akathisia development. We decided to administer 75 mg pregabalin twice daily, resulting in significant symptom improvement. He also complained that he felt the symptoms 10 h after the previous pregabalin dose, suggesting that pregabalin was effective, and its effect weakened or disappeared as time progressed. Akathisia-like symptoms caused by CBDCA-induced CIPN are rare, but they significantly reduce the quality of life. Pregabalin was significantly effective in this case; therefore, we suggest that a detailed symptom interview and selection of the medicine, based upon the action mechanism, are necessary.

  Copyright © 2021 by S. Karger AG, Basel.

• Exceptional Regression of Malignant Pleural Mesothelioma with Pembrolizumab Monotherapy. B.F. Hearon, K.N. Redelman, G.C. Elhomsy, et al. 2020;13(3):1483-1489. Case report PubMed · Publisher · Free full text

  Abstract

  The lead author with clinical stage I malignant pleural mesothelioma, epithelioid type, highly programmed cell death ligand 1 (PD-L1) positive, and BAP1 negative, experienced a prompt and exceptionally favorable response to pembrolizumab monotherapy. After cessation of treatment due to immune-related endocrinopathies, complete metabolic response on interim PET/CT scan was achieved. Two years after initial diagnosis, unifocal tumor reactivation was addressed with successful pembrolizumab monotherapy rechallenge. Immunotherapy, typically not used as frontline treatment for malignant pleural mesothelioma, may provide an effective and durable response for some patients. Based on this single case study, epithelioid type tumors with strongly positive PD-L1 and BAP1-negative immunohistochemical markers may be well suited for treatment with immune checkpoint inhibitors such as pembrolizumab.

  Copyright © 2020 by S. Karger AG, Basel.

2010s

• Chondrosarcoma of the Rib Mimicking Malignant Pleural Mesothelioma. M. Furukawa, H. Tao, T. Tanaka, et al. 2016;9(1):11-4. Case report PubMed · Publisher · Free full text

  Abstract

  A 62-year-old man with a history of long-term asbestos exposure was found to have a chest wall tumor invading the sixth rib on chest computed tomography. The computed tomography also revealed multiple plaques in the pleura. Malignant pleural mesothelioma was suspected, and thoracoscopic surgery was performed. Thoracoscopy revealed that the tumor location was extrapleural. Thus, excisional biopsy was performed. The tumor was histologically diagnosed as chondrosarcoma. Additional wide resection of the chest wall, including the fifth, sixth, and seventh ribs, was performed. Chest wall reconstruction was performed with a polypropylene mesh.

• An Autopsied Case of Malignant Sarcomatoid Pleural Mesothelioma in Which Chest Pain Developed Several Months Earlier without Abnormality on Imaging. D. Yaguchi, M. Ichikawa, N. Inoue, et al. 2015;8(3):439-46. Case report PubMed · Publisher · Free full text

  Abstract

  The patient experienced chest pain for about 7 months, but a diagnosis could not be made until after death. He was diagnosed with malignant sarcomatoid pleural mesothelioma on autopsy. In this case report, difficult aspects of the diagnosis are discussed. The 70-year-old Japanese man was a driver who transported ceramic-related products. Right chest pain developed in July 2013, but no abnormality was detected on a chest computed tomography (CT) performed in September 2013, and the pain was managed as right intercostal neuralgia. A chest CT performed in late October 2013 revealed a right pleural effusion, and the patient was referred to our hospital in early November 2013. Thoracentesis was performed, but the cytology was negative, and no diagnosis could be made. Close examination was postponed because the patient developed a subarachnoid hemorrhage. He underwent (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) after discharge from the neurosurgery department, and extensive right pleural thickening and (18)F-FDG accumulation in this region were observed. Based on these findings, malignant pleural mesothelioma was suspected, and a thoracoscopy was performed under local anesthesia in early December 2013, but no definite diagnosis could be made. The patient selected best supportive care and died about 7 months after the initial development of right chest pain. The disease was definitively diagnosed as malignant sarcomatoid pleural mesothelioma by a pathological autopsy. When chronic chest pain of unknown cause is observed and past exposure to asbestos is suspected, actions to prevent delay in diagnosis should be taken, including testing for suspicion of malignant pleural mesothelioma.

• An unusual case of isolated peritoneal metastases from lung adenocarcinoma. A. Bazine, M. Fetohi, M.R. Khmamouch, et al. 2014;7(2):600-4. Case report PubMed · Publisher · Free full text

  Abstract

  Introduction: Peritoneal metastases from lung cancer are a rare event. In this paper, we report the case of a patient with adenocarcinoma of the lungs who had isolated peritoneal metastases at the time of diagnosis.

  Case Report: We report a 55-year-old female who presented with shortness of breath, decreased effort tolerance, cough, and weight loss. Her initial chest X-ray and subsequent chest CT showed a 12 × 9 × 8 cm mass in the middle lobe of the right lung. The histopathological examination of her biopsy material was consistent with a thyroid transcription factor-1 positive lung adenocarcinoma. In the abdomen, a 5.3-cm mass was identified. A biopsy and immunohistochemistry revealed a lung adenocarcinoma. The patient was administered chemotherapy based on carboplatin-paclitaxel-bevacizumab, but only with a partial response. Six months later, the patient showed brain metastases. Therefore, a second-line treatment based on pemetrexed was administered for 9 courses, and a clinical and radiological response was observed. The chemotherapy was stopped and the patient did not exhibit any symptoms of progression while waiting for a new evaluation.

  Discussion: The incidence of peritoneal involvement of lung cancer without metastases in other parts of the body is scarcely encountered in clinical practice. Out of the different types of lung cancers, adenocarcinoma and large cell carcinoma are most likely to metastasize in the peritoneum. Immunohistochemical staining patterns were important in the differential diagnosis with the other etiologies for peritoneal metastasis and the mesothelioma. Peritoneal metastases are indicative of a disseminated disease and prognosis is extremely poor.

• Phrenic nerve paralysis as the initial presentation in pleural sarcomatoid mesothelioma. G. Makimoto, K. Fujiwara, N. Fujimoto, et al. 2014;7(2):389-92. Case report PubMed · Publisher · Free full text

  Abstract

  A 74-year-old man was referred to our hospital because of persistent cough. A chest radiograph revealed an elevation of the right diaphragm. Computed tomography (CT) images revealed a small nodule localized on the right mediastinum. Five months later, the nodule had grown and was diagnosed as malignant pleural mesothelioma (MPM) by a CT-guided needle biopsy. The patient underwent combined chemotherapy, but the disease progressed rapidly and he passed away. On autopsy, microscopic findings and immunohistological examinations supported the diagnosis of sarcomatoid mesothelioma. Therefore, we diagnosed this rare case as localized sarcomatoid MPM showing phrenic nerve paralysis as an initial presentation.

• Secondary malignant peritoneal mesothelioma of the greater omentum after therapy for primary pleural mesothelioma. A. Gutzeit, C. Reischauer, K. Hergan, et al. 2013;6(1):236-41. Case report PubMed · Publisher · Free full text

  Abstract

  Mesothelioma is the most common malignant primary tumor of the pleura and usually associated with inhalation of asbestos fibers. In contrast, peritoneal mesothelioma is a rare entity whose pathomechanism is not yet fully understood. The coexistence of pleural mesothelioma with secondary involvement of the abdominal cavity has not been addressed in the literature. In this case report, we describe secondary malignant mesothelioma of the greater omentum. A 69-year-old man with histologically proven pleural mesothelioma on the right side and no past medical history of asbestos exposure received palliative treatment consisting of a talc pleurodesis. After a 6-month interval of stable disease, a local progressive tumor of the right pleura was seen on a CT scan. Eleven months later, during follow-up, the patient presented at our emergency department with a sudden onset of diffuse abdominal pain. Abdominal ultrasound revealed a mass within the greater omentum and the coexistence of free fluid. Subsequent abdominal CT scans demonstrated tumor infiltration from the right pleura by a transdiaphragmatic route into the abdomen, where diffuse infiltration of the greater omentum was observed. Aspiration of the ascites and the biopsy of the greater omentum confirmed the diagnosis of secondary malignant mesothelioma of the peritoneum. In conclusion, we present the extremely rare diagnosis of secondary malignant mesothelioma of the abdomen, which arose as a result of local progression from the right pleura into the abdomen.

• Benign cystic mesothelioma of the peritoneum: a rare case and review of the literature. S. Khuri, H. Gilshtein, W. Abboud, et al. 2012;5(3):667-70. Case report PubMed · Publisher · Free full text

  Abstract

  A 19-year-old male presented with right lower quadrant pain. Imaging studies revealed a cystic peritoneal mass. At surgery, a large peritoneal mass was excised. The pathology report revealed a benign cystic mesothelioma, and a right hemicolectomy with cytoreductive surgery was completed.

2000s

• Acute Tubular Necrosis and Interstitial Nephritis during Pemetrexed Therapy. J. Michels, J.P. Spano, I. Brocheriou, et al. 2009;2(1):53-56. Case report PubMed · Publisher · Free full text

  Abstract

  We report a patient with unknown primary undifferentiated carcinoma who developed acute renal failure associated with interstitial fibrosis following pemetrexed therapy. Despite drug withdrawal, renal function remained altered and the patient experienced chronic renal insufficiency. Pemetrexed disodium (Alimta) is a multitargeted antifolate agent approved by the Food and Drug Administration (FDA) for patients diagnosed with mesothelioma and non-small cell lung cancer. This drug is almost exclusively cleared by renal excretion [1]. The most common side effects are hematologic dose-limiting toxicities and nonhematologic toxicities including fatigue, diarrhea, nausea, mucositis and rash. Although few cases of renal failure have been published, no study has reported on the renal pathological findings in this setting. We present a case of acute tubular necrosis associated with interstitial fibrosis after pemetrexed therapy.

• Primary Pericardial Mesothelioma: Report of a Patient and Literature Review. A. Nilsson, T. Rasmuson. 2009;2(2):125-132. Case report PubMed · Publisher · Free full text

  Abstract

  Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient's condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19-76) years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases). Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases). Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months.

Browse every journal in the library or the library by type of article, or return to medical research.