Malignant peritoneal mesothelioma in a 76-year-old woman with a history of asbestos fiber ingestion

Our plain-English summary of Malignant peritoneal mesothelioma in a 76-year-old woman with a history of asbestos fiber ingestion, by P. Van Kesteren, J. Bulten, C. Schijf, et al (International Journal of Gynecological Cancer, 2004).

The study

• Authors: P. Van Kesteren, J. Bulten, C. Schijf, H. Boonstra, L. Massuger
• Journal: International Journal of Gynecological Cancer
• Published: 2004;14(1):162-5
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report on a woman with malignant mesothelioma of the peritoneum. This is the first report of a subject with this disease who revealed a history of asbestos ingestion by asbestos-contaminated food. She presented with episodes of sweating and fever, ascites, and weight loss. At laparotomy, small tumor deposits were noted on the peritoneum. The omental cake was removed, together with the uterus, ovaries, and tubes which were all macroscopically normal. The diagnosis was established by immunohistochemistry and electron microscopy. Postoperatively, her complaints of fever and sweating disappeared. She refused further chemotherapy. After questioning her for asbestos exposure, she told us that, years ago, she used to prepare vegetables for cooking in rain water collected from a roof made of asbestos.

In plain English

This was a case report of one 76-year-old woman in the Netherlands with malignant peritoneal mesothelioma, a cancer of the abdominal lining. She was admitted to a university hospital with malaise, episodes of sweating and fever, weight loss, and fluid in the abdomen (ascites). Her chest CT scan and X-ray showed no signs of pleural mesothelioma. At surgery the omentum, uterus, ovaries and tubes were removed. Tissue staining and electron microscopy led to the diagnosis, which a Dutch mesothelioma panel confirmed. No asbestos bodies were found in the tumor deposits. Her fever and sweating disappeared after surgery, and she chose not to have further chemotherapy. When asked about asbestos exposure, she said that years ago she prepared vegetables for cooking in rain water collected from a roof made of asbestos. The authors wrote that whether this caused her disease is speculative. They noted that the concentration and size of fibers in her water and food were unknown.

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 76-year-old woman admitted to a university hospital in the Netherlands (authors from University Medical Centre St. Radboud, Nijmegen, and Vrije Universiteit Medical Centre, Amsterdam); she had a history of breast cancer treated with lumpectomy and radiotherapy in 1995
• Exposure: Reported ingestion of asbestos through food: years earlier she prepared vegetables for cooking in rain water collected from a roof made of asbestos. No fiber type is named, and the authors state that the fiber concentration and fiber size were unknown.
• Main results:
  • The patient was diagnosed with malignant mesothelioma of the peritoneum after immunohistochemistry and electron microscopy, and the Dutch mesothelioma panel confirmed the diagnosis.
  • The omentum showed nodular tumor deposits ranging from 0.5 to several cm in size.
  • Within the tumor deposits, the staining test for asbestos bodies was negative.
  • The patient showed no signs of pleural mesothelioma on the chest CT scan and X-ray.
  • In this patient, cytology of the ascites showed no malignant cells, and the serum CA-125 level was normal.
  • After the operation the patient's malaise, sweating and fever disappeared. She declined further chemotherapy.
• The authors' conclusion: The authors stated that whether ingesting asbestos fibers caused her disease is speculative. They considered asbestos contamination of her water very likely, citing an earlier report of high fiber levels in cisterns fed by run-off from asbestos cement roofs. They suggested that more people may have a similar history of asbestos ingestion, probably without realizing it.
• Limitations the authors state:
  • The concentration of asbestos fibers in the water she used, the resulting contamination of her food, and the size of the fibers were all unknown.

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, Malignant Mesothelioma, Peritoneum, Ascites, Laparotomy, Immunohistochemistry, Chemotherapy, Asbestos Exposure.

Related studies

• Asbestos in drinking water does not cause mesothelioma — J.H. Lange, J.A. Hoskins (2004)
• Rapid Progression of Malignant Peritoneal Mesothelioma Mimicking a Postoperative Complication in a Young Woman: A Case Report — P.C. Altshuler, A.L. Newman, et al. (2024)
• Asbestos ingestion and gastrointestinal cancer: a possible underestimated hazard — A. Di Ciaula (2017)
• What caused gastrointestinal bleeding in a woman with a history of pleural mesothelioma? Metastatic diffuse epithelioid mesothelioma — F. Iafrate, S. Sibio, et al. (2010)
• Malignant peritoneal mesothelioma in a 16-year-old girl: presentation of a rare disease — I.B. Brecht, A. Agaimy, et al. (2012)
• Metastatic Malignant Peritoneal Mesothelioma Mimicking an Autoinflammatory Syndrome in a 12-Year-Old Boy — G. Olmedilla, C. Undaondo, et al. (2021)

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