Malignant peritoneal mesothelioma in a woman with bilateral ovarian serous borderline tumour: Potential interactions between the two diseases

Our plain-English summary of Malignant peritoneal mesothelioma in a woman with bilateral ovarian serous borderline tumour: Potential interactions between the two diseases, by L. Losi, L. Botticelli, G. Taccagni, et al (Gynecologic Oncology Reports, 2018).

The study

• Authors: L. Losi, L. Botticelli, G. Taccagni, E. Longinotti, C. Lancellotti, L. Scurani, G.F. Zannoni
• Journal: Gynecologic Oncology Reports
• Published: 2018;24:39-42
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We report a case of a 59-year-old woman with peritoneal malignant mesothelioma and no previous exposure to asbestos with a diagnosis of bilateral ovarian serous borderline tumour with peritoneal implants one year before. We discuss the histopathological and immunohistochemical findings to explain possible and potential interactions between the two diseases. To our knowledge, the association of both serous borderline ovarian tumour and malignant peritoneal mesothelioma has never been described before in the same woman and in such a tight temporal connection. This finding raises numerous issues about the origin of the two tumours and further biomolecular studies are needed to fully understand the carcinogenetic process. From a clinical point of view, this case report can be useful to gynaecologists because it leads to recommend a careful examination of the peritoneal cavity during a surgical resection of borderline serous tumour. Moreover, it may suggest performing a close follow-up associated with a careful surveillance of the patient, especially in the case of micropapillary pattern, to oncologists. A complete clinical approach could help to detect sooner possible relapses or other metachronous malignancies.

In plain English

This case report described a 59-year-old woman with no previous exposure to asbestos. One year before the events reported, she had both ovaries and fallopian tubes removed. She was diagnosed with a bilateral serous borderline ovarian tumour with a micropapillary pattern, with non-invasive implants in the omentum, a fatty tissue layer in the abdomen. She refused further treatment, and no surveillance followed. A year later she had emergency surgery for abdominal pain and bowel obstruction. Surgeons found a 20 centimetre abdominal mass infiltrating the uterus and intestinal wall. Tissue examination led to a diagnosis of epithelioid malignant mesothelioma, and the mass contained leftover non-invasive implants of the earlier borderline tumour. Laboratory stains distinguished the two tumours. Calretinin was strongly positive in the mesothelioma but negative in the borderline tumour. Cell growth activity was 90% in the mesothelioma and 10% in the borderline tumour. She died after three weeks. The authors hypothesized that the mesothelioma was a distinct tumour that had incorporated the implants rather than a transformation of the earlier tumour. They said further biomolecular studies were needed.

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
• Who was studied: One 59-year-old woman with no family history of cancer, unknown BRCA status and no previous exposure to asbestos, referred to the authors' hospital for abdominal pain and large bowel obstruction
• Exposure: The patient had no previous exposure to asbestos; the report concerns a prior bilateral serous borderline ovarian tumour rather than any fiber exposure
• Main results:
  • At the first surgery, one year before referral, the woman was diagnosed with bilateral serous borderline ovarian tumour with a micropapillary pattern and non-invasive implants in the omentum
  • After the first surgery the patient refused additional therapy and no surveillance was carried out
  • At the second, emergency surgery, a 20 centimetre abdominal mass was found infiltrating the uterus and the intestinal wall
  • The mass was diagnosed as epithelioid malignant mesothelioma and contained residual non-invasive implants of the previous serous borderline tumour
  • Calretinin was strongly positive in the mesothelioma cells and negative in the borderline tumour and its implants
  • Proliferative activity was 90% in the mesothelioma and 10% in the borderline tumour
  • CA-125 was negative in the mesothelioma and positive in the borderline tumour; PAX-8 was positive in both tumours
  • The patient died three weeks after the second surgery
• The authors' conclusion: The authors hypothesized that the mesothelioma was a distinct tumour that incorporated the borderline tumour's implants, rather than a transformation of the earlier tumour
• Limitations the authors state:
  • The authors stated that further biomolecular studies are needed to understand how the two tumours arose

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Bilateral, Malignant Mesothelioma, Peritoneal Cavity, Surgical Resection, Micropapillary.

Related studies

• Evaluation of MTAP immunohistochemistry loss of expression in ovarian serous borderline tumors as a potential marker for prognosis and progression — N. Nilforoushan, N.A. Moatamed (2020)
• 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)
• A comparative immunohistochemical study of peritoneal and ovarian serous tumors, and mesotheliomas — N. Khoury, U. Raju, et al. (1990)
• PAX8 Expression in a Subset of Malignant Peritoneal Mesotheliomas and Benign Mesothelium has Diagnostic Implications in the Differential Diagnosis of Ovarian Serous Carcinoma — D.B. Chapel, A.N. Husain, et al. (2017)
• The diagnostic and molecular characteristics of malignant mesothelioma and ovarian/peritoneal serous carcinoma — B. Davidson (2011)
• The diagnostic utility of PAX8 immunostaining of malignant peritoneal mesothelioma presenting as serous ovarian carcinoma: A single-center report of two cases — K. Nakamura, K. Nakayama, et al. (2017)

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