Malignant peritoneal mesothelioma following radiotherapy for seminoma of the testis

Our plain-English summary of Malignant peritoneal mesothelioma following radiotherapy for seminoma of the testis, by R.J. Stock, Y.S. Fu, J.R. Carter (Cancer, 1979).

The study

• Authors: R.J. Stock, Y.S. Fu, J.R. Carter
• Journal: Cancer
• Published: 1979;44(3):914-9
• Type of article: Case report
• Cited by: 75 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001059).

Abstract

The difficulties encountered in establishing a diagnosis of a malignant peritoneal mesothelioma are emphasized in a patient who developed the lesion 16 years after radiation therapy for a seminoma of the testis. Historically, histologically, electron microscopically, and by microincineration, there was no evidence of asbestos exposure. We believe that present lesion may be a consequence of prior radiation therapy.

In plain English

This was a case report from the Institute of Pathology at Case Western Reserve University in Cleveland. It described one man, a physician raised in New England with no known asbestos exposure. At age 50 he had a seminoma (a testicular cancer) removed and then received 3200 rads of radiation to the lower abdomen and pelvis. Sixteen years later he developed a lump in the right groin. Pathologists at five institutions agreed it was a cancer that had spread from elsewhere, but they proposed several possible origins, including mesothelioma. Surgery then found widespread nodules over the lining of the abdomen. He later died, and the autopsy showed a purely epithelial peritoneal mesothelioma. It lay mainly on the surface linings, with tumor also in both chest cavities. The lungs showed no fibrosis or ferruginous bodies, and electron microscopy after microincineration of lung and abdominal tissues found no asbestos fibers. The authors noted that this does not totally exclude asbestos. They believed the tumor may have been a consequence of the earlier radiation therapy, and they used the case to show how difficult the diagnosis can be.

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, including autopsy)
• Who was studied: One male physician, born, reared and educated in New England, a nonsmoker, reported from the Institute of Pathology, Case Western Reserve University and University Hospitals of Cleveland
• Exposure: Radiation therapy of 3200 rads to the lower abdomen and pelvis after removal of a testicular seminoma at age 50. No known environmental, occupational or recreational asbestos exposure.
• Main results:
  • A right groin mass measuring 3 x 2.5 cm appeared 16 years after the radiation therapy
  • Biopsy material was sent to pathologists at five institutions. All judged it a metastatic malignant lesion but considered several possible origins (seminoma, amelanotic melanoma, renal cell carcinoma, Leydig cell tumor, adrenal cortical carcinoma, hepatoma, malignant fibrous histiocytoma, mesothelioma).
  • At exploratory surgery, diffuse nodules covered the peritoneal surfaces
  • At autopsy the tumor was mainly serosal, with only minimal, superficial invasion of the intestinal walls. Both pleural cavities contained effusions with tumor plaques.
  • The tumor was histologically a purely epithelial mesothelioma
  • The lungs showed no interstitial fibrosis or ferruginous bodies
  • Microincineration of samples from both lungs, diaphragm, peritoneum, mesentery and omentum, followed by electron microscopy, found no asbestos fibers
• The authors' conclusion: The authors believed the peritoneal mesothelioma may have been a consequence of the prior radiation therapy
• Limitations the authors state:
  • The authors stated that failing to find asbestos fibers does not totally exclude the possibility of asbestos as a cause

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Asbestos Exposure.

Related studies

• Malignant peritoneal mesothelioma associated with deep vein thrombosis following radiotherapy for seminoma of the testis — F. Sato, H. Yamazaki, et al. (2000)
• Long-term outcomes following post-operative radiotherapy for Stage I/II testicular seminoma - an Australasian single-institution experience — W.L. Ong, L. Nazareth, et al. (2016)
• Malignant mesothelioma following radiation exposure — K.H. Antman, J.M. Corson, et al. (1983)
• Colon cancers and peritoneal mesothelioma occurring 29 years after abdominal radiation for testicular seminoma. A case report and review of the literature — D. Tassile, A.D. Roth, et al. (1998)
• Concomitant malignant mesothelioma of the pleura, peritoneum, and tunica vaginalis testis — V. Ascoli, F. Facciolo, et al. (1996)
• Multiple primary malignancies — R.S. Hoffman, A.H. Rossof, et al. (1984)

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