Leptomeningeal infiltration of malignant mesothelioma

Our plain-English summary of Leptomeningeal infiltration of malignant mesothelioma, by B. Oksüzoğlu, S. Yalçin, M. Erman, et al (Medical Oncology, 2002).

The study

• Authors: B. Oksüzoğlu, S. Yalçin, M. Erman, S. Dağdelen
• Journal: Medical Oncology
• Published: 2002;19(3):167-9
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma is a disease mostly involving the pleura, peritoneum, and pericardium. Hematogenously disseminated metastases involving the liver, adrenal glands, kidneys, and contralateral lung have been documented in some patients, but central nervous system (CNS) involvement, especially as leptomeningeal infiltration, is very rare. A 44-yr-old mesothelioma patient admitted to hospital with convulsions and diffuse leptomeningeal infiltration was shown with magnetic resonance imaging. She had a positive history for environmental asbestos exposure. Pleural and axillary lymph node biopsies were consistent with mesothelioma. Diffuse leptomeningeal infiltration is the only constant radiological finding reported as a diagnostic criteria for CNS involvement and histopathological confirmation is usually possible only at autopsy, so clinical and radiological diagnosis is essential after exclusion of other possible causes.

In plain English

This is a case report of one patient, a 44-year-old woman seen at a cancer institute in Ankara, Turkey. She had a history of environmental asbestos exposure for more than 20 years. The article does not name a fiber type. She first came to hospital after four months of shortness of breath, malaise and weight loss. Scans showed thickening of both pleurae and diffuse peritoneal thickening resembling peritoneal mesothelioma. A pleural biopsy showed malignant mesothelioma, and a biopsy of an armpit lymph node was consistent with its spread. Two weeks after starting paclitaxel and cisplatin chemotherapy, she had generalized convulsions. A brain MRI showed diffuse leptomeningeal infiltration (spread into the membranes covering the brain), with clots in brain venous sinuses, bleeding and swelling. Her spinal fluid showed no cancer cells. Central nervous system involvement by mesothelioma was diagnosed from the imaging after other causes were excluded, not from tissue. The authors concluded that, because tissue confirmation is usually possible only at autopsy, diagnosis relies on clinical and radiological findings after other possible causes are excluded.

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 (one patient)
• Who was studied: One 44-year-old female patient at Hacettepe University, Institute of Oncology, Ankara, Turkey
• Exposure: Environmental asbestos exposure for more than 20 years; no fiber type, product or job is named
• Main results:
  • CT showed nodular thickening of the right pleura, diffuse left pleural thickening, and diffuse peritoneal thickening resembling peritoneal mesothelioma infiltration
  • Pleural biopsy showed malignant mesothelioma; excisional biopsy of the right axillary lymph node was reported as consistent with metastasis of malignant mesothelioma
  • Cisplatin-based chemotherapy (135 mg/m2 paclitaxel and 75 mg/m2 cisplatin) was started; two weeks later the patient had generalized tonic-clonic convulsions
  • Cranial MRI showed diffuse leptomeningeal infiltration with thrombosis in the superior sagittal and transverse sinuses, bilateral frontal and left temporal hemorrhages, and edema
  • Lumbar puncture: clear, colorless cerebrospinal fluid with 66 mg/dL glucose and 25 mg/dL protein; no malignant cells were seen
  • The diagnosis of central nervous system involvement of mesothelioma was established from the radiological findings after other causes were excluded
• The authors' conclusion: The authors concluded that, because histopathological confirmation is usually possible only at autopsy, clinical and radiological diagnosis is essential after other possible causes are excluded

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: Malignant Mesothelioma, Mesothelioma, Pleura, Peritoneum, Pericardium, Asbestos Exposure, Autopsy.

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