Malignant peritoneal mesothelioma giving rise to multiple intestinal polyps

Our plain-English summary of Malignant peritoneal mesothelioma giving rise to multiple intestinal polyps, by F.G. Mayall, A.R. Gibbs (Histopathology, 1991).

The study

• Authors: F.G. Mayall, A.R. Gibbs
• Journal: Histopathology
• Published: 1991;18(5):480-2
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This brief report described one patient, a 70-year-old retired engineer who came to hospital with a blocked intestine. During abdominal surgery, many tumour deposits were found on the outer surface of the bowel and mesentery. Part of the small bowel was removed, and tissue examination showed malignant peritoneal mesothelioma. The article states there was no history of asbestos exposure. The patient died 3 months later. At autopsy, the small bowel contained at least 40 polyp-like growths up to 2 cm across. None were seen in the large bowel or stomach. The authors judged that these growths had invaded inward from the bowel's outer surface rather than arising from its lining. Microscope, staining and electron-microscope findings pointed to tubulopapillary malignant mesothelioma. There was no evidence of asbestos-related lung disease. A lung mineral fibre count of 11 million per gram of dried lung, including amosite 0.2 million and crocidolite 0.1 million, was within the range the authors had seen in normal, unexposed people. The authors concluded this was the first reported case of mesothelioma giving rise to multiple intestinal polyps.

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, with autopsy)
• Who was studied: one 70-year-old retired engineer who presented with intestinal obstruction, seen at Llandough Hospital, Penarth, UK (report submitted 1990)
• Exposure: The article reports no history of asbestos exposure. Lung mineral fibres were counted by electron microscopy at autopsy.
• Main results:
  • Malignant peritoneal mesothelioma was diagnosed on the resected small bowel. The patient died 3 months later.
  • At autopsy, the small bowel contained at least 40 polypoid lesions measuring up to 2 cm.
  • No polyps were seen in the large bowel or stomach, although tumour deposits were spread over the outer (serosal) surface.
  • The authors considered that the polyps had invaded from the serosa rather than arising from the bowel lining.
  • Tumour cells were strongly positive for cytokeratin and negative for carcino-embryonic antigen (CEA). The authors used this pattern to distinguish mesothelioma from adenocarcinoma.
  • At autopsy there was no evidence of asbestos-related lung disease.
  • The patient's lung mineral fibre count was 11 × 10⁶ (11 million) per gram of dried lung, including amosite 0.2 × 10⁶ and crocidolite 0.1 × 10⁶. Most of the fibres were mullite (9.4 × 10⁶). The authors stated this was within the range they had encountered in normal, unexposed individuals.
• The authors' conclusion: The authors concluded this was the first reported case of malignant mesothelioma giving rise to multiple intestinal polyps. In their view, it shows the diversity of patterns in peritoneal mesothelioma and supports considering this tumour when diagnosing abdominal tumours.
• Limitations the authors state:
  • The authors noted that, apart from the microvilli, ultrastructural details in the post-mortem tissue examined by electron microscopy were poorly preserved.

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.

Related studies

• Well-differentiated papillary mesothelioma, possibly giving rise to diffuse malignant mesothelioma: a case report — K. Washimi, T. Yokose, et al. (2013)
• Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature — S.C. Frontario, A. Loveitt, et al. (2015)
• Mucin-positive epithelial mesothelioma of the peritoneum: small bowel involvement — J.H. Kim, K.Y. Kwon, et al. (2011)
• Benign cystic peritoneal mesothelioma incorrectly diagnosed as an ovarian borderline mucinous tumor of intestinal type at transvaginal preoperative ultrasound evaluation — A.C. Testa, G.F. Zannoni, et al. (2011)
• Diffuse malignant peritoneal mesothelioma presenting as intestinal obstruction — J. Griniatsos, S. Sougioultzis, et al. (2009)
• Asbestos exposure — D.L. Davis (1992)

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