Malignant mesothelioma with bone metastases

Our plain-English summary of Malignant mesothelioma with bone metastases, by W.F. Cheng, A.W. Berkman (Medical and Pediatric Oncology, 1990).

The study

• Authors: W.F. Cheng, A.W. Berkman
• Journal: Medical and Pediatric Oncology
• Published: 1990;18(2):165-8
• Type of article: Case report, Review
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma has rarely been reported to metastasize to bone. This is a report of a 71-year-old man who presented with pleural mesothelioma. After a course of chemotherapy, the patient developed lower back pain. Plain X-ray and bone scan were negative for metastases, but magnetic resonance imaging (MRI) revealed multiple metastatic lesions to the thoracolumbar vertebrae. Subsequent lumbar spine biopsy confirmed the presence of malignant mesothelioma. The patient then received radiation therapy. This report illustrates an unusual presentation for malignant mesothelioma and shows that, in addition, when bone metastases are clinically suspected, MRI may be a useful adjunct to more conventional imaging approach.

In plain English

This article was a case report describing one patient. He was a 71-year-old man who had worked for 30 years as a steelyard worker, had a history of asbestos exposure, and had smoked two packs of cigarettes a day for 50 years. The article does not name the type of asbestos fiber. A biopsy of his right pleura showed malignant pleural mesothelioma of the biphasic type. He received six cycles of chemotherapy with adriamycin, which was stopped when he developed chest and flank pain. He then reported low back pain. A plain X-ray of the spine and a bone scan did not show spread of the cancer, but MRI showed multiple metastatic lesions in the thoracolumbar vertebrae. A lumbar spine biopsy confirmed mesothelioma, and he was treated with radiation therapy. He died 10 months after the original diagnosis. A limited autopsy found tumor spread to the heart, bone and abdominal organs. The authors concluded that this was an unusual presentation and that MRI may be a useful addition to conventional imaging when bone metastases are suspected.

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)
• Who was studied: One 71-year-old man with pleural mesothelioma. The authors were at the Division of Medical Oncology, Harbor Hospital Center, Baltimore.
• Exposure: Worked as a steelyard worker for 30 years with a history of asbestos exposure (fiber type not stated). He also smoked two packs of cigarettes per day for 50 years.
• Main results:
  • The right pleural biopsy showed malignant mesothelioma of biphasic type.
  • After six cycles of adriamycin chemotherapy, the patient developed right chest and flank pain, and chemotherapy was stopped.
  • A plain X-ray of the spine and a bone scan were negative for metastases, but MRI showed multiple metastatic lesions in the thoracolumbar vertebrae. The authors reported that in this case MRI was more sensitive than plain X-ray or bone scan.
  • A lumbar spine biopsy showed tumor cells with epithelioid features, with the spindle form predominant. The patient was then treated with radiation therapy.
  • The patient died 10 months after the original diagnosis.
  • The autopsy was limited to the right lung and pleura. It found malignant mesothelioma involving the right lung, pleura and right diaphragm, with multiple sites of metastases to the heart, bone and abdominal organs.
• The authors' conclusion: The authors concluded that the case illustrated an unusual presentation of malignant mesothelioma. They also concluded that when bone metastases are clinically suspected, MRI may be a useful adjunct to more conventional imaging.

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, Metastasis, Pleural Mesothelioma, Chemotherapy, Biopsy.

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