Malignant Deciduoid Mesothelioma: case presentation of an exceptional variant and review of the literature

Our plain-English summary of Malignant Deciduoid Mesothelioma: case presentation of an exceptional variant and review of the literature, by M. Khmou, S. Echcharif, R. Kabbaj, et al (BMC Clinical Pathology, 2017).

The study

• Authors: M. Khmou, S. Echcharif, R. Kabbaj, B.E. Khannoussi
• Journal: BMC Clinical Pathology
• Published: 2017;17:13
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant Deciduoid Mesothelioma (MDM) is an extremely rare variant of epithelioid mesothelioma. It was first described in young females, in the peritoneum, and its relation with asbestos was not well defined. Later reports, have shown that this variant may also occur in the pleura, the pericardium and the tunica vaginalis of elderly people, who had been exposed to asbestos.

Case Presentation: We report a case of malignant deciduoid mesothelioma that occurred in the peritoneal cavity, and the omentum of a 35-year-old woman. The patient had never been exposed to asbestos.

Conclusions: Through this observation, we describe clinical, histopathological, and immunohistochemical findings of deciduoid mesothelioma, and review the literature reports.

In plain English

This is a case report of one patient, with a review of earlier published cases. The authors described a 35-year-old woman with no medical history who was admitted with symptoms suggesting appendicitis. The article states she had never been exposed to asbestos. Surgery found multiple firm white-to-gray nodules spreading through the peritoneal cavity (the space inside the abdomen's lining) and the omentum. Microscope examination showed sheets of large malignant epithelioid cells, and stains were positive for mesothelial markers such as calretinin. The findings were judged compatible with deciduoid malignant mesothelioma, a rare variant of epithelioid mesothelioma. The patient received 5 cycles of chemotherapy and had survived 12 months at the time of the report. Reviewing the literature, the authors counted 25 earlier reported cases of peritoneal deciduoid mesothelioma, 17 of them in females, with patients overall aged 8 to 78. They reported five cases linked to asbestos exposure, all in elderly patients. The authors concluded that pathologists should recognize this rare variant and that studies of more cases are needed.

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 of a single patient, with a review of previously published cases
• Who was studied: one 35-year-old woman with no medical history, admitted for an appendicular syndrome. The authors work in a pathology department in Rabat, Morocco. No dates are given.
• Exposure: none: the patient had never been exposed to asbestos
• Main results:
  • Exploratory surgery (laparotomy) found multiple firm white-to-gray nodules infiltrating the peritoneal cavity and the omentum.
  • Under the microscope, the biopsy showed sheets of malignant cells made up only of large pleomorphic epithelioid cells.
  • Tumor cells were positive for cytokeratin AE1/AE3, calretinin, D2-40, CK5/6 and WT-1.
  • Tumor cells were negative for Ber-EP4, CEA, estrogen and progesterone receptors, and HMB-45.
  • The microscopic and staining findings were judged compatible with deciduoid malignant mesothelioma.
  • The patient received 5 cycles of chemotherapy and had a survival of 12 months at the time of the report.
  • Literature review (other authors' cases, not this study's): 25 cases of peritoneal deciduoid mesothelioma had been reported, 17 of them female. Patients overall ranged in age from 8 to 78 years. In Table 1 the 78-year-old is male, and the listed females are aged 8 to 64.
  • Literature review (other authors' cases): 19 cases were described as unrelated to asbestos. The five cases associated with asbestos exposure were in elderly patients.
• The authors' conclusion: The authors concluded that this variant is rare and that pathologists need to recognize it, because it is easily confused with other diagnoses. They believe studies of a larger number of cases may help define it further.
• Limitations the authors state:
  • The authors note that there are no large survival studies of this variant because it is so rare.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Epithelioid, Peritoneum, Pleura, Pericardium, Tunica Vaginalis, Peritoneal Cavity, Omentum.

Related studies

• 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: a rare variant of epithelioid mesothelioma — L. Taylor, D. Cooper, et al. (2019)
• Is the Deciduoid Variant of Pleural Mesothelioma Significant? — A. Aujayeb, L. Taylor (2020)
• Deciduoid mesothelioma: cytologic presentation and diagnostic pitfalls — C.C. Huang, C.W. Michael (2013)
• Peritoneal Deciduoid Mesothelioma: An Unusual Presentation Complicating an Already Challenging Diagnosis — N. Dominiak, W. Graybill, et al. (2017)
• Deciduoid mesothelioma: report of 21 cases with review of the literature — N.G. Ordóñez (2012)

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