Malignant deciduoid mesothelioma: a rare variant of epithelioid mesothelioma

Our plain-English summary of Malignant deciduoid mesothelioma: a rare variant of epithelioid mesothelioma, by L. Taylor, D. Cooper, A. Aujayeb (BMJ Case Reports, 2019).

The study

• Authors: L. Taylor, D. Cooper, A. Aujayeb
• Journal: BMJ Case Reports
• Published: 2019;12(7)
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We describe a case of a deciduoid mesothelioma, a rare variant of epithelioid mesothelioma, which is associated with a very poor prognosis. A review of the relevant literature is also included. The patient was a man with probable asbestos exposure and presented with classic features of pleural malignancy. Diagnosis was reached with close correlation between clinical, radiological and pathological findings.

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

In plain English

This article was a case report of one patient, with a short discussion of published literature. It described a 71-year-old man seen at a pleural clinic after six months of cough, left-sided chest pain and worsening breathlessness. He had worked as an apprentice electrician, in construction, in naval shipyards and as a soft drinks engineer. The authors judged that he had almost certainly been exposed to asbestos in the past, although he could not recall specific exposures. Later reviews of his scans and of the thoracoscopy video found no pleural plaques. Scans showed a large left pleural effusion with pleural nodules and thickening. Testing of the fluid was inconclusive, so biopsies were taken during a thoracoscopy. Tissue testing was most consistent with epithelioid malignant mesothelioma with a deciduoid pattern, a rare variant. He was referred for palliative chemotherapy with pemetrexed and carboplatin. The disease was stable after two cycles but later progressed significantly. The authors concluded that their case adds to the evidence on this rare condition.

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) with brief discussion of the literature
• Who was studied: one 71-year-old man referred to a pleural clinic (Northumbria Healthcare NHS Foundation Trust, North Shields, UK)
• Exposure: probable historic occupational asbestos exposure, inferred from work as an apprentice electrician, in construction, in naval shipyards and as a soft drinks engineer. The patient could not recall specific exposures, and no fiber type is named.
• Main results:
  • The chest X-ray showed a large left pleural effusion. The CT scan showed pleural nodules, effusion, and pleural and mediastinal thickening.
  • Cytology of the drained pleural fluid was inconclusive, so a medical thoracoscopy with biopsies was performed.
  • The biopsy findings were most consistent with epithelioid malignant mesothelioma with a deciduoid pattern.
  • Tumour cells were positive for mesothelioma markers (CK AE1/3, calretinin, CK5/6, WT1m, D240, CD141). They were negative for epithelial markers (Ber-EP4, CEA, p40, TTF-1, CD15).
  • On retrospective review, the scans showed no pleural plaques or other asbestos deposits. No plaques were seen on the thoracoscopy video.
  • The disease was stable after two cycles of pemetrexed and carboplatin but later progressed significantly.
• The authors' conclusion: The authors concluded that their case adds to the evidence base on malignant deciduoid mesothelioma, a rare entity.
• Limitations the authors state:
  • The asbestos exposure was inferred from the patient's job history. He could not recall specific exposures.

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: Mesothelioma, Epithelioid, Prognosis, Asbestos Exposure.

Related studies

• Deciduoid mesothelioma: a report of 5 cases and literature review — J. Shia, R.A. Erlandson, et al. (2002)
• Is the Deciduoid Variant of Pleural Mesothelioma Significant? — A. Aujayeb, L. Taylor (2020)
• Myxoid variant epithelioid pleural mesothelioma defines a favourable prognosis group: an analysis of 191 patients with pleural malignant mesothelioma — F.S. Alchami, R.L. Attanoos, et al. (2017)
• Mesotheliomas with deciduoid morphology: a morphologic spectrum and a variant not confined to young females — J.H. Shanks, M. Harris, et al. (2000)
• Malignant Deciduoid Mesothelioma: case presentation of an exceptional variant and review of the literature — M. Khmou, S. Echcharif, et al. (2017)
• Lymphohistiocytoid mesothelioma: a rare lymphomatoid variant of predominantly sarcomatoid mesothelioma — D.W. Henderson, H.D. Attwood, et al. (1988)

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