Malignant mesothelioma presenting as a giant chest, abdominal and pelvic wall mass

Our plain-English summary of Malignant mesothelioma presenting as a giant chest, abdominal and pelvic wall mass, by Z.H. Shao, X.L. Gao, X.H. Yi, et al (Korean Journal of Radiology, 2011).

The study

• Authors: Z.H. Shao, X.L. Gao, X.H. Yi, P.J. Wang
• Journal: Korean Journal of Radiology
• Published: 2011;12(6):750-3
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

In plain English

This article was a case report from Tongji Hospital of Tongji University in Shanghai, China. It described one patient, a 77-year-old woman who was a housewife and who denied any history of exposure to asbestos dust or poisonous chemicals. She had noticed a growing lump in her right abdominal wall a year earlier, and later developed shortness of breath after physical activity. Examination found a giant irregular tumor in the right chest, abdominal and pelvic walls. Fluid around the right lung contained malignant tumor cells. CT scans showed a poorly defined mass invading the muscle layers of the body wall and extending into the abdominal cavity, with no significant pleural thickening or lung lesion. Biopsy and immunohistochemistry confirmed malignant mesothelioma. Because the tumor was very large and extensively invasive, surgery was not possible and radiotherapy was not done; she died six months later. The authors concluded that this was a peritoneal mesothelioma that had directly invaded the body walls. They also concluded that features seen on CT and MRI may help make an exact diagnosis. As a single-patient report, it gives no rate.

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
• Who was studied: One 77-year-old woman, a housewife, treated at Tongji Hospital of Tongji University, Shanghai, China
• Exposure: No asbestos exposure reported: the patient denied any history of exposure to asbestos dust and poisonous chemicals
• Main results:
  • Fluid drained from around the right lung contained malignant tumor cells on cytological examination
  • CT showed a giant irregular soft-tissue mass in the right thoracoabdominal wall and both pelvic walls that had extensively invaded the muscle layers of the wall
  • On unenhanced CT the tumor measured between 32 and 48 Hounsfield units
  • There was no significant pleural thickening and no abnormal lesion in either lung
  • Biopsy staining and immunohistochemistry confirmed malignant mesothelioma, consistent with the mixed type
  • The authors concluded the tumor was a peritoneal mesothelioma that had directly invaded the chest, abdominal and pelvic walls
  • Because the tumor was very large and extensively invasive, surgery was not possible and radiotherapy was not done
  • The patient was treated for her symptoms and died six months later
• The authors' conclusion: The authors concluded that CT attenuation, MRI signal intensity, the pattern of contrast enhancement, diffuse involvement of the body wall and peritoneal or pleural thickening are features that may help tell body wall mesothelioma apart from other infiltrative soft-tissue tumors and help make an exact diagnosis
• Limitations the authors state:
  • The authors noted that diagnosis depends on pathology and that the imaging findings are not specific
  • The authors noted that only a few such cases have been reported with CT images, so the imaging features of body wall mesothelioma had not been described in detail

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Carcinoma, Mesothelial Cells, Peritoneal Cavity, Mesothelioma, Bilateral, Pathology, Immunohistochemistry.

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