Localized malignant pleural mesothelioma

Our plain-English summary of Localized malignant pleural mesothelioma, by T. Nakano, R. Hamanaka, K. Oiwa, et al (General Thoracic and Cardiovascular Surgery, 2012).

The study

• Authors: T. Nakano, R. Hamanaka, K. Oiwa, K. Nakazato, R. Masuda, M. Iwazaki
• Journal: General Thoracic and Cardiovascular Surgery
• Published: 2012;60(7):468-74
• Type of article: Case report
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Localized malignant pleural mesothelioma (LMPM) is a rare tumor; previously only 52 cases have been reported in the English literature. This type of tumor should be distinguished from diffuse malignant pleural mesothelioma, because a good outcome may be obtained by surgical resection. We report a case of LMPM which grew rapidly within 1 year. Surgical resection was performed, and at present, 6 months since the operation, the patient remains free of the disease.

In plain English

This was a case report from a thoracic surgery department in Japan. It included the authors' tally of previously published cases of localized malignant pleural mesothelioma, a rare form that appears as a single distinct lump without spread across the pleura. The patient was a 46-year-old long-distance truck driver who had smoked about 30 cigarettes daily for 26 years and had no history of asbestos exposure. A chest X-ray at an annual checkup showed a mass not visible on an X-ray a year earlier; CT measured it at about 90 mm across. Surgeons removed the tumor with the left upper lobe of the lung and regional lymph nodes. It was diagnosed as the biphasic type. The lymph nodes and surgical margins were free of tumor, and he was disease-free 6 months after surgery. Of 52 previously reported cases, the authors counted 20 (38.5 %) with a positive asbestos exposure history. The authors concluded that surgery may give a good outcome. They also said that, with so few reported cases, an association with asbestos could not be definitively 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, with the authors' summary of previously published cases
• Who was studied: one 46-year-old man treated at Tokai University School of Medicine, Isehara, Kanagawa, Japan; dates of treatment not given
• Exposure: no history of asbestos exposure; smoked about 30 cigarettes daily for 26 years; worked as a long-distance truck driver
• Main results:
  • In the patient, CT showed a mass about 90 mm in diameter; a chest X-ray taken a year earlier showed left pleural thickening but not the mass
  • The patient's tumor stained positive for cytokeratin and calretinin and negative for TTF-1 and CEA, and was diagnosed as localized malignant pleural mesothelioma of the biphasic type
  • In the patient, the removed lymph nodes and the surgical margins were negative for tumor
  • The patient remained free of disease 6 months after the operation
  • Among 52 previously reported cases of localized malignant pleural mesothelioma in the English literature, 20 (38.5 %) had a positive asbestos exposure history
  • Across the 53 reported cases including this one, the histological subtypes were epithelial 52.8 %, sarcomatoid 15.1 % and biphasic 32.1 %
  • Of 13 reported cases where the pleura of origin was described, 11 (85 %) arose from the parietal pleura and 2 from the visceral pleura
• The authors' conclusion: The authors concluded that a good outcome may be obtained with surgery, so this tumor should be carefully distinguished from diffuse malignant pleural mesothelioma. They also concluded that, given the small number of reported cases, an association with asbestos exposure could not be definitively excluded, and that more cases are needed to clarify the tumor's nature and establish standard therapy.
• Limitations the authors state:
  • The small number of cases reported to date limits conclusions about any link with asbestos exposure
  • It could not be determined which pleura (parietal or visceral) the patient's tumor originated from
  • The usefulness of chemotherapy and radiation therapy added to surgery has not been evaluated

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Surgical Resection.

Related studies

• Benign localized fibrous tumor of the pleura: report of 25 new cases — S. Enon, D. Kilic, et al. (2012)
• Minute localized malignant pleural mesothelioma coexisting with multiple adenocarcinomas — R. Maeda, N. Isowa, et al. (2010)
• Huge malignant solitary fibrous tumor of the pleura — W.A. Arab, D. Lamoth, et al. (2012)
• Localized malignant mesothelioma, an unusual and poorly characterized neoplasm of serosal origin: best current evidence from the literature and the International Mesothelioma Panel — A.M. Marchevsky, A. Khoor, et al. (2020)
• Localized malignant lymphohistiocytoid pleural mesothelioma — A. Ouazzani, B. Rondelet, et al. (2011)
• Solitary fibrous tumor of the pleura — A. Orki, A. Kosar, et al. (2008)

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