Malignant mesothelioma invading the spinal canal

Our plain-English summary of Malignant mesothelioma invading the spinal canal, by D. Cooper (Postgraduate Medical Journal, 1974).

The study

• Author: D. Cooper
• Journal: Postgraduate Medical Journal
• Published: 1974;50(589):718-23
• Type of article: Case report
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

A case of diffuse malignant pleural mesothelioma presenting as acute paraplegia is described. Autopsy revealed the presence of metastatic tumour within the spinal cord. An alveolar cell carcinoma coexisting with the mesothelioma and giving a distinct histological pattern was also present. There was no histological evidence of asbestos exposure.

In plain English

This was a case report about one man, aged 67, admitted to hospital in January 1971 with sudden paralysis of the right leg, followed by gradual paralysis of the left. He had worked in the dockyards of Portsmouth but was not known to have handled asbestos material, and he was a non-smoker. Examination showed signs of transection of the spinal cord at the T8 level. He died 24 days after admission. At autopsy, a tumour 1-3 cm thick filled the lower right pleural cavity. Tumour deposits were found in and around the spinal cord, which at T8 had been virtually replaced by tumour. Under the microscope the pleural tumour was a diffuse malignant pleural mesothelioma. A second, separate cancer, an alveolar cell carcinoma of the lung, was also present. An exhaustive search of lung and tumour sections found no asbestos bodies and no lung fibrosis, although the author noted that the thoroughness of the search may be open to question. The author suggested that the spinal cord deposits had spread through the bloodstream. The author concluded that the two tumours can co-exist and show distinct microscopic features.

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 autopsy)
• Who was studied: One man aged 67 years, admitted to hospital in January 1971 with paralysis of the legs
• Exposure: Worked in the Portsmouth dockyards but not known to have handled asbestos material. No fiber type is named, and no asbestos bodies were found at autopsy.
• Main results:
  • Neurological examination showed signs of transection of the spinal cord at T8
  • The patient died 24 days after admission
  • At autopsy, the lower right pleural cavity was filled by a confluent pleural tumour 1-3 cm thick
  • At the T8 level the spinal cord had been virtually replaced by tumour
  • The pleural tumour was a diffuse malignant pleural mesothelioma, infiltrated by a separate multifocal peripheral alveolar cell carcinoma
  • The author placed the mesothelioma in the mixed cell type category
  • No asbestos bodies were found in sections of each lung lobe and several tumour blocks, and there was no fibrosis or cavitation in the lung tissue
  • The author suggested that the deposits inside the spinal cord arose by blood-borne spread
• The authors' conclusion: The author concluded that an alveolar cell carcinoma of the lung and a malignant pleural mesothelioma can co-exist and give distinct microscopic features. Although this case was not associated with asbestos exposure, the author suggested that an as yet unidentified causal factor could have produced both tumours.
• Limitations the authors state:
  • The author acknowledged that the thoroughness of the search for evidence of asbestos exposure may be open to question
  • A test for hyaluronic acid to support the mesothelioma diagnosis failed because the tissues had been fixed in formalin

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: Malignant Mesothelioma, Pleural Mesothelioma, Autopsy, Carcinoma, Mesothelioma, Asbestos Exposure.

Related studies

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• Brown-Séquard Syndrome in a Desmoplastic Malignant Mesothelioma Patient: A Rare Complication — M. Ralki, A. Serrien, et al. (2021)
• Spinal cord ischemia resulting in paraplegia following extrapleural pneumonectomy — K. Ural, K. Jakob, et al. (2014)
• Malignant mesothelioma of the peritoneum invading the liver and mimicking metastatic carcinoma: a case report — S. Nagata, M. Tomoeda, et al. (2011)
• Nucleolin and nucleophosmin expression patterns in pulmonary adenocarcinoma invading the pleura and in pleural malignant mesothelioma — M. Masiuk, P. Waloszczyk, et al. (2020)
• Strategy for the treatment of patients with spinal neoplasms — P. Kluger, A. Korge, et al. (1997)

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