Malignant mesothelioma with brain metastases

Our plain-English summary of Malignant mesothelioma with brain metastases, by J.A. Kaye, A.M. Wang, C.L. Joachim, et al (The American Journal of Medicine, 1986).

The study

• Authors: J.A. Kaye, A.M. Wang, C.L. Joachim, S.E. Seltzer, E. Cibas, A. Skarin, K.H. Antman
• Journal: The American Journal of Medicine
• Published: 1986;80(1):95-7
• Type of article: Case report
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Although malignant mesothelioma is known to spread hematogenously, brain metastases are rare. In the patient presented herein, multiple unilateral symptomatic central nervous system metastases developed that were diagnosed by computed tomography and documented at autopsy. Since malignant mesothelioma is occurring more frequently in the population at risk (asbestos workers), this complication may be observed more commonly in the future.

In plain English

This article is a case report from Boston about one patient whose malignant mesothelioma spread to the brain. The patient, a 48-year-old man, had smoked three packs of cigarettes a day and had worked in a naval shipyard for 34 years. The report does not describe a specific asbestos exposure or fiber type for him. A rib resection in January 1983 showed sarcomatoid malignant mesothelioma, which kept spreading through two chemotherapy regimens. In December 1983 the patient developed confusion, slurred speech and left-sided weakness, and a brain CT scan showed multiple masses on the right side. Dexamethasone and whole-brain radiation did not help. The patient died on January 5, 1984, one year after diagnosis. Autopsy found five right-sided brain lesions of 0.5 to 1.5 cm, consistent with the primary pleural mesothelioma. The authors reported seeing no documented brain metastases among 200 mesothelioma patients at their institute since 1965. They concluded that mesothelioma should not be excluded in patients with known asbestos exposure, a chest mass and brain metastases on CT.

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 48-year-old man, a heavy smoker and long-term naval shipyard worker, first seen at another hospital in August 1982 and then treated at the Dana-Farber Cancer Institute, Boston
• Exposure: 34 years of work in a naval shipyard, plus smoking three packs of cigarettes per day; the article does not describe the patient's asbestos exposure or name any fiber type
• Main results:
  • A rib resection in January 1983 showed a spindle cell tumor consistent with the sarcomatoid variant of malignant mesothelioma
  • Brain metastases appeared in the setting of widespread disease after two sequential chemotherapy regimens
  • In December 1983 a cranial CT scan showed multiple masses in the right side of the patient's brain
  • The patient's condition worsened despite dexamethasone and whole-brain radiation therapy
  • The patient died on January 5, 1984, one year after diagnosis
  • At autopsy, mesothelioma involved both lungs and pleurae, with metastases in the vertebrae, mesentery, right atrium and liver
  • At autopsy, the brain deposits measured 0.5 to 1.5 cm and were compatible with the primary pleural mesothelioma
  • At autopsy, a perforated peptic ulcer was found in the duodenum
  • The authors reported that among 200 malignant mesothelioma patients seen at their institute since 1965, none had documented brain metastases
• The authors' conclusion: The authors concluded that, although lung cancer is statistically more likely, mesothelioma should not be ruled out in patients with known asbestos exposure, a mass inside the chest, and brain metastases seen on CT. They also suggested that brain metastases from mesothelioma may become more common.

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, Autopsy.

Related studies

• Response to chemotherapy of brain metastases from malignant pleural mesothelioma — M. Colleoni, G. Liessi, et al. (1996)
• Brain metastases in malignant pleural mesothelioma. Case report and review of the literature — K.S. Sridhar, A.M. Hussein, et al. (1989)
• Brain metastases in malignant pleural mesothelioma — T. Yamagishi, N. Fujimoto, et al. (2016)
• Meningeal and brain metastases in primary malignant pericardial mesothelioma — U. Bohn, J.L. Gonzalez, et al. (1994)
• Brain Metastasis of Pleural Mesothelioma after a Subarachnoid Hemorrhage — A. Hirooka, A. Tamiya, et al. (2016)
• Brain metastasis in malignant pleural mesothelioma presenting as intratumoral hemorrhage — T. Ishikawa, H. Wanifuchi, et al. (2010)

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