Malignant mesothelioma metastatic to the oral region and latest topics (Review)

Our plain-English summary of Malignant mesothelioma metastatic to the oral region and latest topics (Review), by Y. Ohnishi, T. Fujii, T. Sakamoto, et al (Molecular and Clinical Oncology, 2020).

The study

• Authors: Y. Ohnishi, T. Fujii, T. Sakamoto, M. Watanabe, T. Motohashi, H. Kubo, M. Nakajima
• Journal: Molecular and Clinical Oncology
• Published: 2020;13(5):61
• Type of article: Review
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma (MM) is a rare neoplasm with poor prognosis that usually develops after exposure to asbestos, and is characterised by aggressive local invasion and metastatic spread. While metastasis to the oral cavity is very rare, a total of 23 cases of MM metastasising to the oral cavity were identifed. Among those, the tongue was the most common site of metastasis (39.1%), and frequently involved the epithelioid MM cell type. Recent studies have elucidated the mechanisms underlying the development of MM. Chronic inflammation has been implicated in promoting MM growth and was shown to play a key role by driving the release of high mobility group box protein 1 following asbestos deposition. Inherited heterozygous germline mutations in the deubiquitylase BRCA-associated protein 1 were shown to increase the incidence of MM in some families. Infection by the simian virus 40 was also found to be associated with the occurrence of MM. Moreover, the increasing incidence rates of MM, together with its propensity to metastasise to the oral cavity, indicate that clinicians and pathologists should be highly aware of this disease. Furthermore, identification of novel serum biomarkers would enable better screening and treatment of MM, and improve the survival outcomes.

Copyright © 2020, Spandidos Publications.

In plain English

This article was a review by authors from Osaka Dental University in Japan. It covered malignant mesothelioma in general and focused on cases where the cancer had spread (metastasised) to the mouth. The authors searched the PubMed database and the reference lists of related papers for published case reports and identified 23 such cases. Of these, 19 patients were men. The authors gave the mean age at diagnosis as 61.7 years (range 35 to 75). The tongue was involved in 9 of the 23 (39.1%), mostly of the epithelioid cell type. Three cases were of the sarcomatoid type, and all three involved the back part of the lower jaw. The review also summarised other researchers' work on how asbestos-related inflammation, a protein called HMGB-1, inherited BAP1 gene mutations and the virus SV40 may relate to mesothelioma. These were not findings of this review. The collected cases were not described by asbestos exposure. The authors concluded that, although mouth metastases are rare, precise diagnosis by tissue examination and immunohistochemical staining is recommended to avoid unnecessary overtreatment.

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: Narrative review, including a literature search of published case reports of malignant mesothelioma that spread to the mouth
• Who was studied: 23 published cases of malignant mesothelioma metastatic to the oral cavity, found through a PubMed search and manual review of reference lists. The case reports were published between 1993 and 2020.
• Exposure: No exposure data were given for the collected cases. The review discussed, from other studies, the association of asbestos fibres (no fiber types named), erionite, radiotherapy, SV40 and inherited BAP1 mutations with mesothelioma.
• Main results:
  • 23 cases of malignant mesothelioma metastatic to the oral cavity were identified in the literature
  • Among the 23 cases, 19 patients were men, a men-to-women ratio of 4.8 to 1
  • The mean age at diagnosis of the 23 cases was reported as 61.7 years, range 35 to 75 years
  • The tongue was the metastatic site in 9 of the 23 (39.1%), most of them epithelioid type
  • The sarcomatoid type was found in 3 cases, all in the posterior part of the mandible (lower jaw)
  • In one patient (case 14), the oral lesions were the first sign of mesothelioma, which was ultimately diagnosed as pleural mesothelioma
• The authors' conclusion: The authors concluded that, although oral metastases from mesothelioma are rare, precise diagnosis using histological and immunohistochemical analysis is recommended to avoid unnecessary overtreatment and to improve survival and quality of life.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Neoplasm, Prognosis, Metastasis, Epithelioid, Chronic Inflammation, Deposition, Germline Mutation.

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