Localized benign pleural mesothelioma arising in a radiation field

Our plain-English summary of Localized benign pleural mesothelioma arising in a radiation field, by J.K. Hill, R.F. Heitmiller, F.B. Askin, et al (Clinical Imaging, 1997).

The study

• Authors: J.K. Hill, R.F. Heitmiller, F.B. Askin, J.E. Kuhlman
• Journal: Clinical Imaging
• Published: 1997;21(3):189-94
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Localized benign pleural mesothelioma is a rare neoplasm representing less than 5% of all pleural tumors. Unlike the malignant diffuse pleural mesothelioma, there is no evidence of a relationship to asbestos exposure. Essentially, the cause of localized benign pleural mesotheliomas remains obscure. We propose that one mechanism of the development of this tumor is prior ionizing radiation to the tumor field. Ionizing radiation is a well-known human oncogen and leads to an increased incidence of benign tumors as well. A 65-year-old woman had a localized benign pleural mesothelioma of her left upper chest 22 years following adjuvant radiation therapy to the left breast and axillary region for a breast carcinoma.

In plain English

This article is a case report about one patient. The authors described a 65-year-old woman who had a localized benign pleural mesothelioma in her left upper chest 22 years after cobalt radiation therapy to her left breast and armpit area. She had received that treatment after left breast cancer diagnosed in 1972. A routine chest X-ray, taken while she was in hospital for rehydration after viral gastritis, showed a smooth 7-cm mass. A chest X-ray five years earlier had been normal. Surgeons removed the tumor. It measured 8.2 by 6.5 by 5.2 cm and arose from the visceral pleura, the lining that covers the lung. Under the microscope it looked like a solitary fibrous benign tumor of the pleura. Nearby lung showed scarring that the authors said was perhaps consistent with earlier radiation injury. Her recovery was uneventful. The authors stated that, unlike malignant diffuse pleural mesothelioma, this tumor type has no known link to asbestos. The article does not mention the patient's asbestos history. The authors proposed that the earlier radiation predisposed her to the tumor. This is one patient's history, not a measure of risk.

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 65-year-old woman with a history of breast cancer in both breasts (left 1972, right 1979), treated with mastectomies. She was first seen for rehydration after viral gastritis and later evaluated at Johns Hopkins Hospital, Baltimore. The year of the tumor diagnosis is not stated.
• Exposure: Cobalt radiation therapy to the left axillary (armpit) and breast area after left breast cancer. No dose is given. The article does not report any asbestos exposure for this patient. The authors state that localized benign pleural mesothelioma has no known relationship to asbestos.
• Main results:
  • Chest X-ray showed a smooth, pleural-based 7-cm soft tissue mass in the left upper chest (left lung apex). A chest X-ray five years earlier had been normal, indicating the lesion was new.
  • The surgically removed tumor measured 8.2 X 6.5 X 5.2 cm and arose from the visceral pleura.
  • Microscopic examination of the tumor showed histology consistent with a solitary fibrous benign tumor of the pleura.
  • Lung next to the tumor showed focal extensive pulmonary fibrosis, which the article describes as perhaps consistent with prior radiation injury.
  • Separately removed apical pleura had a firm white plaque measuring 3.7 X 2.5 (no unit given). Under the microscope it showed reactive mesothelium with fibrosis and chronic inflammation.
  • The resection was considered adequate, and the patient's recovery after surgery was uneventful.
• The authors' conclusion: The authors proposed that the prior radiation therapy to her left breast and axilla predisposed this patient to developing a localized benign pleural mesothelioma. They also stated that this tumor should be considered when a well-circumscribed, smooth, pleural-based mass arises in a radiation field.

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, Neoplasm, Asbestos Exposure, Carcinoma.

Related studies

• Malignant mesothelioma following radiation exposure — K.H. Antman, J.M. Corson, et al. (1983)
• Lung cancer in relation to employment in the electrical utility industry and exposure to magnetic fields — D.A. Savitz, V. Dufort, et al. (1997)
• Localized mesothelioma tumour arising synchronously with a primary contralateral lung cancer — W. Andrews, S. Paul, et al. (2013)
• Localized multiple malignant epithelioid peritoneal mesotheliomas arising from the hepatoduodenal ligament and diaphragm: a case report — T. Miyata, Y. Fujiwara, et al. (2019)
• Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS) — D.B. Richardson, E. Cardis, et al. (2015)
• Ionizing radiation: a risk factor for mesothelioma — J.E. Goodman, M.A. Nascarella, et al. (2009)

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