Localized malignant mesothelioma of the epithelial type occurring as a primary hepatic neoplasm: a case report with review of the literature

Our plain-English summary of Localized malignant mesothelioma of the epithelial type occurring as a primary hepatic neoplasm: a case report with review of the literature, by J. Imura, K. Ichikawa, J. Takeda, et al (APMIS, 2002).

The study

• Authors: J. Imura, K. Ichikawa, J. Takeda, Y. Iwasaki, S. Tomita, K. Kubota, T. Fujimori
• Journal: APMIS
• Published: 2002;110(11):789-94
• Type of article: Case report
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report a localized malignant mesothelioma of the epithelial type, occurring as a primary hepatic neoplasm in a 64-year-old male. He was found to have a mass located in the right lobe of the liver. Surgery was carried out with resection of the mass from the right hepatic lobe, with partial resection of the diaphragm. Grossly, an ill-defined tumor was present in the hepatic parenchyma. Histologically, the tumor displayed a predominant tubular pattern of growth with a desmoplastic stroma. The tubules were lined by a single layer of cuboidal or flattened cells with pleomorphic vesicular nuclei. A hyaluronidase-digestible, mucin-like substance was demonstrated in the lumen and tumor cytoplasm. The tumor cells were immunohistochemically positive for calretinin, HBME-1, cytokeratin, i.e. AE1/AE3 and CAM 5.2, but negative for carcinoembryonic antigen, CD 34 and Leu M1. Moreover, the tumor cells showed nuclear accumulation of the p53 oncopotein and reacted frequently with Ki-67 antibody. These findings support the concept that malignant mesothelioma of the epithelial type may occur at extrapleural sites. To the best of our knowledge, this is the first reported case of localized malignant primary mesothelioma arising in the liver.

In plain English

This article was a case report, with a short discussion of earlier published cases. It described a 64-year-old man who had worked as a welder in a car factory. The authors wrote that asbestos exposure was not reported. The patient was being treated for chronic hepatitis and tested positive for hepatitis C virus. A tumor was found in the right lobe of the liver, which was cirrhotic. Surgeons removed the tumor together with part of the liver and the diaphragm. On laboratory staining, the tumor cells were positive for calretinin, HBME-1 and cytokeratins and negative for carcinoembryonic antigen, CD 34 and Leu M1. The authors read this pattern as showing mesothelial differentiation. Many tumor cells showed p53 accumulation, and the Ki-67 labeling index averaged 25%. A small number of tumor cells had invaded the diaphragm but not its peritoneal surface. No disease was found up to 40 months after surgery. The authors concluded that malignant mesothelioma of the epithelial type may occur outside the pleura. They called this the first reported case of localized malignant primary mesothelioma in the liver.

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 with a brief review of the literature
• Who was studied: one 64-year-old man in Japan (Dokkyo University School of Medicine) with a mass in the right lobe of the liver
• Exposure: The patient had worked as a welder in a car factory. Asbestos exposure was not reported.
• Main results:
  • The patient tested positive for hepatitis C virus RNA.
  • The tumor was located in a micronodular cirrhotic liver.
  • The tumor cells were positive for calretinin, HBME-1 and cytokeratins (AE1/AE3 and CAM 5.2).
  • The tumor cells were negative for carcinoembryonic antigen, CD 34 and Leu M1.
  • The authors stated that the staining profile of the tumor cells showed mesothelial differentiation.
  • The tumor cells showed nuclear accumulation of p53 and reacted frequently with Ki-67 antibody.
  • The Ki-67 labeling index of the tumor cells averaged 25%.
  • Small numbers of tumor cells invaded the adherent diaphragm but did not infiltrate its peritoneal surface.
  • No clinical or radiologic evidence of disease was found up to 40 months after resection.
• The authors' conclusion: The authors concluded that the findings support the concept that malignant mesothelioma of the epithelial type may occur at extrapleural sites. They stated that, to their knowledge, this was the first reported case of localized malignant primary mesothelioma arising in the liver.

Topics

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

Medical terms in this study, explained in our Lexicon: Localized Malignant Mesothelioma, Neoplasm, Diaphragm, Parenchyma, Desmoplastic Mesothelioma, Tubule, Pleomorphic, Calretinin.

Related studies

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• Collision tumour of the pleura composed of small cell carcinoma and malignant mesothelioma — A.H. Lee, I.N. Soomro (2004)
• Primary thymic epithelial tumours of the pleura mimicking malignant mesothelioma — R.L. Attanoos, F. Galateau-Salle, et al. (2002)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Immunohistochemical panels for differentiating epithelial malignant mesothelioma from lung adenocarcinoma: a study with logistic regression analysis — R. Carella, G. Deleonardi, et al. (2001)
• Multiple primary hepatic malignant mesotheliomas mimicking cystadenocarcinomas on enhanced CT and FDG PET/CT — A. Dong, H. Dong, et al. (2014)

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