Localized mesothelioma tumour arising synchronously with a primary contralateral lung cancer

Our plain-English summary of Localized mesothelioma tumour arising synchronously with a primary contralateral lung cancer, by W. Andrews, S. Paul, N. Narula, et al (Interactive Cardiovascular and Thoracic Surgery, 2013).

The study

• Authors: W. Andrews, S. Paul, N. Narula, N.K. Altorki
• Journal: Interactive Cardiovascular and Thoracic Surgery
• Published: 2013;17(6):1061-2
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelioma is a malignant growth of mesothelial cells found in the serosal membrane of pleural, peritoneal and pericardial surfaces as a result of prolonged exposure to asbestos. Malignant pleural mesothelioma (MPM) typically presents itself in a diffuse pattern of growth over the pleura of the lung or in more rare cases as a localized focus (LMPM). We present the first reported case of a synchronous LMPM and non-small adenocarcinoma of the lung treated by sequential resections.

In plain English

This was a case report of one patient in New York. An 82-year-old man, a former smoker, saw his doctor for left-sided back pain. Scans showed a 7.2 cm left lower lobe mass invading a rib and a 5.4 cm right lower lobe lesion. Needle biopsies led doctors to think both were separate lung cancers. After left-sided surgery, the tumour proved to be a localized malignant mesothelioma, epithelioid type, of the left lung pleura. The resection margins and lymph nodes were negative for tumour. He returned eight weeks later, and part of his right lower lobe was removed; it was a 5.0 cm stage IB adenocarcinoma. He received six cycles of pemetrexed and was free of recurrent disease 10 months after his surgeries. The article did not describe any asbestos exposure for this patient. The authors cited one earlier report of localized mesothelioma with multiple adenocarcinomas. They said a localized mesothelioma arising with an adenocarcinoma of the opposite lung had never been reported. They said the case showed how hard mesothelioma and lung adenocarcinoma can be to tell apart on small biopsies.

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 82-year-old male former smoker with hypertension, type II diabetes mellitus and emphysema, treated at New York Presbyterian Hospital-Weill Cornell Medical College, New York
• Exposure: Not reported. The article gives no asbestos exposure history for this patient. The link between mesothelioma and asbestos appears only as general background in the abstract.
• Main results:
  • CT scan showed a 7.2 cm left lower lobe mass invading the seventh rib and a 5.4 cm right lower lobe sub-solid opacity
  • After needle biopsies, the two lesions were thought to be synchronous primary lung cancers
  • Pathology of the resected left-sided tumour showed a localized malignant mesothelioma, epithelioid type, of the left lung pleura
  • All resection margins and lymph nodes from the left-sided surgery were negative for tumour
  • The mesothelioma diagnosis was made only after resection, not from the earlier biopsy
  • The resected right-sided tumour was a T2a, N0, M0 stage IB 5.0 cm moderately differentiated adenocarcinoma
  • After six cycles of adjuvant pemetrexed, the patient remained free of recurrent disease 10 months after the sequential resections
  • The authors noted a single earlier report of a localized mesothelioma arising with multiple adenocarcinomas. They stated that a localized mesothelioma arising synchronously with a non-small-cell adenocarcinoma of the contralateral lung had never been reported.
• The authors' conclusion: The authors concluded that this was the first reported case of a localized malignant pleural mesothelioma arising synchronously with a non-small-cell adenocarcinoma of the contralateral lung, treated by sequential surgical resection. They said the case illustrates the difficulty of distinguishing mesothelioma from lung adenocarcinoma using only limited tissue from core biopsies.

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: Localized Malignant Mesothelioma, Lung Cancer, Mesothelioma, Mesothelial Cells, Pericardial, Pleural Mesothelioma, Pleura, Adenocarcinoma.

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