Malignant mesothelioma mimicking ovarian cancer

Our plain-English summary of Malignant mesothelioma mimicking ovarian cancer, by M.J. Merino (International Journal of Surgical Pathology, 2010).

The study

• Author: M.J. Merino
• Journal: International Journal of Surgical Pathology
• Published: 2010;18(3 Suppl):178S-180S
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This article described malignant mesotheliomas whose first sign was a mass in the ovary, a presentation that can be mistaken for ovarian cancer. The author, at the National Cancer Institute in Bethesda, Maryland, studied 7 such cases. All patients underwent surgery with a primary diagnosis of ovarian cancer. The patients were reported as 22 to 52 years old (mean 32.7 years, median 33 years). On imaging and gross examination, 4 ovarian masses were mainly cystic and 3 mainly solid. They measured 3.8 to 9 cm (mean 5.76 cm). Six patients had peritoneal and/or omental involvement. All 4 cystic tumors were multicystic mesotheliomas. One solid tumor looked like ovarian serous and clear cell carcinoma under the microscope, but its immunostaining profile was that of malignant mesothelioma. In another patient, the mesothelioma occurred with a borderline mucinous ovarian tumor, which raised the possibility of a sarcomatoid mural nodule. Immunostains and electron microscopy supported a diagnosis of mesothelioma with a biphasic immunoprofile. The author noted that these patients were younger than those in earlier published series, which had an average age of 52 years. The author also suggested that some reported sarcoma-like mural nodules could be spindle cell mesotheliomas. The author concluded that mesothelioma can present as an ovarian mass in young women, that a high index of suspicion and ancillary studies are needed for correct diagnosis, and that awareness of this presentation is important for choosing surgical and adjuvant therapy.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short report described 7 patients whose abdominal mesothelioma first appeared as an ovarian mass. All 7 had surgery with an initial diagnosis of ovarian cancer. The report did not say where or when the cases arose, and it did not mention asbestos or any other exposure. The patients were 22 to 52 years old (mean 32.7 years, median 33 years), although the text later described the oldest patient as 55. Four tumors were mainly cystic and three were solid. All of the cystic tumors were multicystic mesotheliomas. The masses measured 3.8 to 9 cm, and six patients had disease on the peritoneum and/or omentum. One solid tumor resembled ovarian serous and clear cell carcinoma. In another patient, a mesothelioma occurred alongside a borderline mucinous ovarian tumor, and special stains and electron microscopy supported the mesothelioma diagnosis. The author concluded that mesotheliomas can present as ovarian masses in young women, and that a high index of suspicion and additional tests are needed for a correct diagnosis.

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 series (short pathology report)
• Who was studied: 7 patients with mesothelioma that first appeared as an ovarian mass, aged 22 to 52 years (mean 32.7, median 33). The article later calls the oldest patient 55. Where and when the cases were collected is not stated.
• Exposure: Not reported; the article does not mention asbestos or any other exposure.
• Main results:
  • All 7 patients had surgery with a primary diagnosis of ovarian cancer.
  • Of the 7 tumors, 4 were mainly cystic and 3 were solid; all of the cystic tumors were multicystic mesotheliomas.
  • The ovarian masses measured 3.8 to 9 cm (mean 5.76 cm), and 6 of the 7 patients had peritoneal and/or omental involvement.
  • One of the 3 solid tumors resembled ovarian serous and clear cell carcinoma.
  • In one patient with a borderline mucinous tumor, immunostains and electron microscopy supported a diagnosis of mesothelioma; the malignant component had the immunoprofile of a biphasic mesothelioma.
  • The oldest patient (described as 55) presented with vaginal bleeding and an adnexal mass, and at surgery had disease spread through the abdomen.
• The authors' conclusion: The author concluded that mesotheliomas can present as ovarian masses in young women, and that a high index of suspicion and ancillary studies are needed for a correct diagnosis.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Ovarian Cancer, Omental Involvement, Multicystic Mesothelioma (MCM), Carcinoma, Mesothelioma, Sarcomatoid, Biphasic Mesothelioma.

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• Cytomorphology of ovarian clear cell carcinomas in peritoneal effusions — D. Damiani, V. Suciu, et al. (2016)
• Perineal talc exposure and epithelial ovarian cancer risk in the Central Valley of California — P.K. Mills, D.G. Riordan, et al. (2004)
• Rapid Progression of Malignant Peritoneal Mesothelioma Mimicking a Postoperative Complication in a Young Woman: A Case Report — P.C. Altshuler, A.L. Newman, et al. (2024)
• A new policy regarding ovarian resection in young women treated for peritoneal carcinomatosis — D. Elias, E. Duchalais, et al. (2013)
• Evaluation of MTAP immunohistochemistry loss of expression in ovarian serous borderline tumors as a potential marker for prognosis and progression — N. Nilforoushan, N.A. Moatamed (2020)

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