Localized Intrasplenic Mesothelioma: A Case Report

Our plain-English summary of Localized Intrasplenic Mesothelioma: A Case Report, by M. Giansanti, G. Bellezza, A. Guerriero, et al (International Journal of Surgical Pathology, 2014).

The study

• Authors: M. Giansanti, G. Bellezza, A. Guerriero, A. Pireddu, A. Sidoni
• Journal: International Journal of Surgical Pathology
• Published: 2014;22(5):451-5
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is a primary neoplasm of the serosal membranes that usually presents with a diffuse pattern of growth. However, cases of localized mesotheliomas have been described. The predominant localization is the pleura; peritoneum and pericardium being rarer localizations. Only few cases of true intraparenchymal mesothelioma arising in organs such as liver, gonads, lung, and pancreas have been described. We report a case of an otherwise healthy 48-year-old man without asbestos exposure with a nodule of 3 cm in diameter, localized in the spleen, discovered incidentally at the ultrasonographic examination, for which histopathological and immunohistochemical findings were consistent with epithelioid mesothelioma: large round cells with eosinophil dense cytoplasm and macronucleoli and with immunohistochemical positivity for pancytokeratins, calretinin, Wilms tumor-1, and others markers of mesothelial differentiation. The diagnosis of localized intrasplenic epithelioid malignant mesothelioma was carried out. To the best of our knowledge, this is the first case of a localized intrasplenic mesothelioma published in the indexed literature.

© The Author(s) 2013.

In plain English

This article is a case report describing one patient: a 48-year-old man with no asbestos exposure who had two months of upper abdominal (epigastric) pain. An ultrasound found a solid lesion in the spleen, and a CT scan showed a 3.4 by 2.6 cm mass with no enlarged lymph nodes, no blood-vessel invasion and no other abnormal findings. A needle biopsy showed a malignant tumor made of large epithelioid cells. Immunohistochemical staining was positive for several markers of mesothelial cells, including calretinin and Wilms tumor-1, and negative for markers of other tumor types. The authors considered this consistent with epithelioid mesothelioma. The spleen was removed a month later. The 3.4 cm tumor lay inside the spleen tissue without touching its capsule. The authors stated that imaging and surgery ruled out spread from a mesothelioma of the peritoneum or pleura. The patient was well and disease-free one year after surgery. The authors concluded that, to their knowledge, this was the first reported case of mesothelioma arising inside the spleen, and that reports of similar cases would help characterize it.

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
• Who was studied: One 48-year-old man with no asbestos exposure who had a 2-month history of epigastric pain. The article does not state where or when the patient was treated.
• Exposure: No asbestos exposure was reported for this patient. No fiber type or job is described.
• Main results:
  • CT showed a 3.4 by 2.6 cm ovoid, inhomogeneous mass in the spleen, without lymphadenopathy or vascular invasion. No other pathologic lesions were noted.
  • The needle biopsy showed a solid epithelioid malignant tumor of large polygonal cells with many mitotic figures.
  • Tumor cells were positive for pancytokeratins, cytokeratin 7, EMA, calretinin, WT1, D2.40, HBME1 and CD141. They were negative for cytokeratins 5/6, CD10, CD31, CD34, Fli1, S100, HMB45, MelanA, TTF1, PSA, Villin, RCCag, B72.3 and synaptophysin. These findings were considered consistent with epithelioid mesothelioma.
  • The removed spleen measured 14 by 9.8 by 4 cm (311 g). It contained a well-circumscribed gray mass 3.4 cm in largest diameter, confined to the splenic tissue without contact with the capsule.
  • Radiologic examinations and findings during surgery were used to exclude secondary involvement of the spleen by a peritoneal or pleural mesothelioma.
  • The patient had an uneventful recovery and was well and disease-free 1 year after splenectomy.
• The authors' conclusion: The authors concluded that, to the best of their knowledge, this was the first report of an intrasplenic malignant mesothelioma, and that reports of similar cases will be useful to characterize the features and biological behavior of splenic mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Malignant Mesothelioma, Neoplasm, Localized Malignant Mesothelioma, Pleura, Peritoneum, Pericardium, Asbestos Exposure.

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