Localized malignant pleural mesothelioma with renal metastasis

Our plain-English summary of Localized malignant pleural mesothelioma with renal metastasis, by S.J. Zardawi, B.T. Li, M.G. Zauderer, et al (Oxford Medical Case Reports, 2015).

The study

• Authors: S.J. Zardawi, B.T. Li, M.G. Zauderer, J.W. Wang, B.B. Atmore, T.A. Barnes, N. Pavlakis, M.N. Mathur, S. Clarke
• Journal: Oxford Medical Case Reports
• Published: 2015;2015(1):170-2
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Localized malignant pleural mesothelioma (LMM) is a rare subset of malignant pleural mesothelioma. Its epidemiology, biology, natural history and optimal treatment are poorly understood. We report a case of LMM treated aggressively with complete surgical resection and adjuvant radiotherapy, but subsequently complicated by local chest wall recurrence and solitary metastasis to the kidney. This case is examined in the context of a small number of cases of LMM in the literature to emphasize the existence of this rare disease entity, their unusual biological behaviour and the need for further tumour molecular and genomic research.

In plain English

This article was a case report of one patient with localized malignant pleural mesothelioma, a rare form of pleural mesothelioma that forms a defined mass rather than encasing the lung. The patient was a 67-year-old Caucasian man who had smoked 50 pack-years and had been exposed to asbestos 50 years earlier. The article did not say what type of asbestos or what job was involved. Scans found a 40-mm lung lesion touching the pleura. He first declined surgery. Three months later the tumour measured 80 mm and had grown into the chest wall. Surgery then completely removed a 78-mm biphasic mesothelioma, and he had radiotherapy afterwards. Five months later a 47-mm metastasis was found in the left kidney. After two cycles of chemotherapy, the tumour came back at the left pleura. He died 14 months after his first diagnosis. The authors wrote that, to their knowledge, this was the first reported case of localized mesothelioma spreading to the kidney. They concluded that the disease is rare, poorly understood and needs further research. As a single case, it does not show how often this happens.

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 67-year-old Caucasian male smoker (50 pack-years), treated at Royal North Shore Hospital, Sydney, Australia
• Exposure: History of asbestos exposure 50 years before presentation. Fiber type, products and occupation were not stated.
• Main results:
  • Initial imaging showed a new 40-mm left upper lobe lesion next to the pleura.
  • After he declined surgery, the tumour had grown to 80 mm three months later and extended into the left chest wall.
  • Surgery completely removed a 78-mm Stage III (T3N0M0) poorly differentiated biphasic mesothelioma. This was followed by adjuvant radiotherapy of 60 Gy in 30 fractions.
  • Five months later, a biopsy of a kidney lesion confirmed metastatic sarcomatoid mesothelioma.
  • He received two cycles of carboplatin and pemetrexed palliative chemotherapy, which he tolerated poorly. CT later showed recurrence at the left pleura.
  • The patient died at home 14 months after primary diagnosis and 4 months after diagnosis of metastatic disease.
• The authors' conclusion: The authors concluded that this was, to their knowledge, the first case of localized malignant pleural mesothelioma with renal metastasis in the literature. They said it highlights an unpredictable disease course and the need for further research.

Topics

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

Related studies

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• Pseudomesotheliomatous carcinoma due to pleural metastasis from renal pelvic cancer — Y. Katsuya, M. Fukusumi, et al. (2014)
• A case of localized peritoneal malignant mesothelioma with ovarian metastasis and literature review — J. Wang, R. Hu, et al. (2022)
• Localized gastric mesothelioma with nodal metastasis-an exceptionally rare entity — M. Kazi, T. Vispute, et al. (2022)
• The epidemiology of renal cell carcinoma — L. Lipworth, R.E. Tarone, et al. (2006)
• Occupational risk factors for renal cell carcinoma: agent-specific results from a case-control study in Germany. MURC Study Group. Multicenter urothelial and renal cancer study — B. Pesch, J. Haerting, et al. (2000)

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