Long-term follow-up of a well-differentiated mesothelioma of the peritoneum in a 2-year-old girl

Our plain-English summary of Long-term follow-up of a well-differentiated mesothelioma of the peritoneum in a 2-year-old girl, by L. Wünsch, P. Flemming, A. Reiter (Medical and Pediatric Oncology, 1998).

The study

• Authors: L. Wünsch, P. Flemming, A. Reiter
• Journal: Medical and Pediatric Oncology
• Published: 1998;31(2):123-4
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This brief report described one girl in Germany diagnosed at age 2 with well-differentiated mesothelioma of the peritoneum (the lining of the abdomen) who was still living with the disease 9 years later. At the first operation, small cysts and nodules covered the liver, spleen, omentum and peritoneum, and complete removal was impossible. Under the microscope the cells showed no atypia. The authors reported that no asbestos particles could be observed. Reactive mesothelial hyperplasia, a non-cancerous condition, was also discussed as a possible diagnosis. Alpha-interferon given for 9 weeks produced no measurable reduction of fluid or tumor and was stopped because of severe thrombocytopenia (low platelets). Further operations at ages 6 and 10, the second for bowel obstruction, confirmed the same diagnosis. At 11, her height and weight were in the 3rd percentile, and she had recurrent abdominal pain and visible residual disease. The authors concluded that, until effective drug treatments are developed, a limited surgical approach seems acceptable. This describes one child and 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 (brief report of a single patient)
• Who was studied: One girl diagnosed at age 2 and followed to age 11, treated at the Children's Hospital, Hannover Medical School, Germany
• Exposure: The article does not report any asbestos exposure. On pathologic examination, no asbestos particles were observed.
• Main results:
  • At the first laparotomy, ascites and small cysts and nodules covered the liver, spleen, omentum and peritoneum. Omentectomy, appendectomy and bilateral herniorrhaphy were done, but complete resection was impossible.
  • Pathology showed mesothelial cells with epithelioid differentiation in papillary patterns, without atypia, with few mitoses and with psammoma bodies. No asbestos particles were observed. Well-differentiated mesothelioma was diagnosed, but reactive mesothelial hyperplasia was also discussed.
  • Alpha-interferon given 3 days a week for 9 weeks produced no measurable reduction of ascites or tumor. It was stopped because of severe thrombocytopenia.
  • A second operation was performed at age 6, with superficial resection of nodules. The histopathologic features were unchanged.
  • At age 10 she was readmitted with bowel obstruction caused by a cystic tumor attached to the stomach and transverse colon. This required partial resection of these organs, and the diagnosis was confirmed.
  • At age 11 her height and weight were in the 3rd percentile. She had recurrent attacks of abdominal pain and visible residual disease on ultrasound.
• The authors' conclusion: The authors observed prolonged symptomatic relief and improved growth after incomplete tumor resection. They concluded that, until effective systemic or intraperitoneal treatments are developed, a limited surgical approach seems acceptable.

Topics

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

Medical terms in this study, explained in our Lexicon: Well-Differentiated, Mesothelioma, Peritoneum.

Related studies

• Well-differentiated papillary mesothelioma of the peritoneum: a separate entity — K. Hoekman, G. Tognon, et al. (1996)
• Well-differentiated papillary mesothelioma of the peritoneum: a diagnostic dilemma on fine-needle aspiration cytology — J.G. Nasit, G. Dhruva (2014)
• Well-differentiated papillary mesothelioma of the peritoneum is genetically defined by mutually exclusive mutations in TRAF7 and CDC42 — M. Stevers, J.T. Rabban, et al. (2019)
• Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases — A. Malpica, S. Sant'Ambrogio, et al. (2012)
• Well-differentiated papillary mesothelioma of the peritoneum: a pathological analysis and review of the literature — A.V. Hoekstra, M.W. Riben, et al. (2005)
• Therapeutic strategies for well-differentiated papillary mesothelioma of the peritoneum — Y.K. Lee, H.J. Jun, et al. (2013)

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