Malignant localized fibrous tumor of the pleura occurring in a person environmentally exposed to tremolite asbestos

Our plain-English summary of Malignant localized fibrous tumor of the pleura occurring in a person environmentally exposed to tremolite asbestos, by M. Metintas, A.R. Gibbs, E. Harmanci, et al (Respiration; International Review of Thoracic Diseases, 1997).

The study

• Authors: M. Metintas, A.R. Gibbs, E. Harmanci, N. Ozdemir, O. Paşaoğlu, S. Işiksoy, R. Arslan, S. Erginel, B. Adapinar
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 1997;64(3):236-9
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case is presented of a malignant localized pleural fibroma occurring in a 60-year-old Turkish female who was environmentally exposed to tremolite. The tumor was excised but recurred 3 years later when it was again excised. It is possible that more radical surgery at initial presentation with chest wall resection would have been advantageous.

In plain English

This case report described one woman in Turkey with a malignant localized fibrous tumor of the pleura, the lining of the chest. She was 60 when admitted to hospital in July 1990 with breathlessness, left chest pain, weight loss and fatigue. She had lived since birth in a village in the Kütahya district. There, white soil used to paint and whitewash houses was found on analysis to contain tremolite asbestos. The authors described her as environmentally exposed for 60 years. Surgeons removed a 30 x 20 x 20 cm tumor attached to the parietal pleura by a stalk. Pathologists diagnosed a solitary fibrous tumor but were cautious about her outlook because of nuclear atypia and necrosis. In March 1993 a 10 x 12 x 14 cm chest wall mass had destroyed her shoulder blade, and nodules were seen in both lungs. The removed mass was mostly malignant and resembled a fibrosarcoma. The authors suggested more radical first surgery might have been appropriate. No lung tissue was available for mineral analysis. The authors concluded that, on balance, these tumors appear unrelated to asbestos and that her exposure was coincidental.

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 (one patient)
• Who was studied: one 60-year-old woman who had lived since birth in a village in the Kütahya district of Turkey, admitted to hospital in July 1990 and readmitted in March 1993
• Exposure: environmental exposure to tremolite asbestos from local white soil used for painting and whitewashing houses; analysis of a soil sample showed tremolite asbestos and some fine fibers; the authors described exposure for 60 years and elsewhere called it a potential exposure
• Main results:
  • At the first operation, a 30 x 20 x 20 cm extrapulmonary solitary tumor attached to the parietal pleura by a pedicle was totally excised
  • The first specimen was diagnosed as a solitary fibrous tumor of the pleura, with a guarded prognosis because of areas of nuclear atypia and necrosis
  • Physical findings, including digital clubbing, had disappeared by the time the patient left hospital
  • In March 1993, CT showed a 10 x 12 x 14 cm chest wall mass
  • The recurrent mass had destroyed the scapula, and there were 4 nodules in the right lung and one in the left lung
  • The second specimen was predominantly malignant (necrosis, cellular pleomorphism, numerous mitoses) and was reported to resemble a fibrosarcoma
• The authors' conclusion: The authors concluded that more radical surgery including chest wall resection might have been appropriate at first presentation. They also concluded that, on balance, the evidence suggests localized fibrous tumors of the pleura are unrelated to asbestos exposure and that the exposure in this case was coincidental.
• Limitations the authors state:
  • No lung tissue was available for mineral analysis
  • The authors noted that very few such cases have been linked to asbestos and that no case-control study has shown these tumors to be related to asbestos exposure

Topics

The National Library of Medicine indexes this study under subjects our site covers: Tremolite.

Medical terms in this study, explained in our Lexicon: Solitary Fibrous Tumor, Pleura, Tremolite.

Related studies

• Fine-needle aspiration cytology of localized fibrous tumor of pleura — D. Dusenbery, M.M. Grimes, et al. (1992)
• Solitary fibrous tumors of the pleura: clinical characteristics, surgical treatment and outcome — P. Magdeleinat, M. Alifano, et al. (2002)
• Localized fibrous "mesothelioma" of pleura (submesothelial fibroma): a clinicopathologic study of 18 cases — D. Scharifker, M. Kaneko (1979)
• An epidemiological study in an Anatolian village environmentally exposed to tremolite asbestos — Y.I. Baris, N. Bilir, et al. (1988)
• Benign localized fibrous tumor of the pleura: report of 25 new cases — S. Enon, D. Kilic, et al. (2012)
• A case of giant benign localized fibrous tumor of the pleura — M. Biçer, S. Yaldiz, et al. (1998)

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