Malignant peritoneal mesothelioma presenting with respiratory symptoms

Our plain-English summary of Malignant peritoneal mesothelioma presenting with respiratory symptoms, by M. Daskalogiannaki, P. Prassopoulos, M. Raissaki, et al (European Radiology, 2000).

The study

• Authors: M. Daskalogiannaki, P. Prassopoulos, M. Raissaki, M. Tsardi, N. Gourtsoyiannis
• Journal: European Radiology
• Published: 2000;10(5):814-6
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant peritoneal mesothelioma is a rare disease associated with mild, nonspecific abdominal symptoms and a wide spectrum of imaging findings, with thickened mesentery and peritoneum being the most common ones. A case of a malignant peritoneal mesothelioma presenting with manifestations of pulmonary disease is reported. Imaging evaluation revealed pleural, lung and pericardial involvement together with retroperitoneal lymphadenopathy, little ascites and extensive omental, but only subtle, mesenteric thickening.

In plain English

This case report described one 28-year-old man with malignant peritoneal mesothelioma who sought care for a week of mild breathlessness and dry cough, after 3 months of weight loss (20 pounds) and a month of occasional nausea and abdominal discomfort. Chest CT showed small fluid collections around both lungs, fluid around the heart, and multiple nodules about 0.5 cm across in the lower lungs. Abdominal CT showed a large pelvic mass, extensive involvement of the omentum, only minimal thickening of the mesentery, little ascites (abdominal fluid) and moderately enlarged lymph nodes. Needle biopsy led to a diagnosis of the epithelial type, and mesothelioma cells were found in the fluid around the lungs and heart. The disease progressed over 10 months after chemotherapy began. The authors reported no history of environmental asbestos exposure and no imaging signs of asbestosis. They concluded that peritoneal mesothelioma may present with respiratory complaints, and that a bulky peritoneal mass with extensive omental thickening and disproportionately little ascites should alert radiologists to it.

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 28-year-old man. The authors are from the Departments of Radiology and Pathology, University Hospital of Heraklion, Crete, Greece. No dates of care are given.
• Exposure: The article reports no history of environmental exposure to asbestos and no imaging features indicative of asbestosis. No fiber type, product or job is described.
• Main results:
  • The patient presented with a 1-week history of mild dyspnoea and dry cough. He reported weight loss of 20 pounds over the previous 3 months, followed in the previous month by occasional nausea and abdominal discomfort. These abdominal symptoms came before the respiratory symptoms that brought him in.
  • Chest CT showed small bilateral pleural effusions, pericardial fluid, multiple peripheral pulmonary nodules in the lung bases of approximately 0.5 cm in diameter, and enlarged anterior diaphragmatic lymph nodes.
  • Abdominal CT showed a large, well-defined soft tissue pelvic mass with extensive omental infiltration. It also showed minimal thickening of the small bowel mesentery, little ascites and moderate retroperitoneal lymph node enlargement.
  • Percutaneous needle biopsy of the pelvic mass led to a final diagnosis of malignant peritoneal mesothelioma of the epithelial type. Staining and immunocytochemistry excluded adenocarcinoma.
  • Pleural and pericardial fluid contained malignant mesothelioma cells. This was taken as metastatic thoracic disease responsible for the respiratory symptoms.
  • Over 10 months of follow-up after chemotherapy began, the disease increased. Omental thickening progressed, ascites increased and the metastatic chest disease worsened.
• The authors' conclusion: The authors concluded that peritoneal mesothelioma may present with respiratory complaints and imaging suggesting metastatic chest disease. In their view, a bulky peritoneal mass with extensive omental thickening and disproportionately little ascites should alert the radiologist to likely peritoneal mesothelioma, even without severe mesenteric involvement. To their knowledge, such a presentation without thoracic asbestos-related changes had not been reported before.

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, Mesentery, Peritoneum, Pericardial, Lymphadenopathy, Ascites.

Related studies

• Correlation between respiratory symptoms and pulmonary function in asbestos-exposed workers — C.A. Brodkin, S. Barnhart, et al. (1993)
• Longitudinal analysis of respiratory symptoms in population studies with a focus on dyspnea in marine transportation workers — V.H. Arrandale, M. Koehoorn, et al. (2009)
• Longitudinal pattern of reported respiratory symptoms and accelerated ventilatory loss in asbestos-exposed workers — C.A. Brodkin, S. Barnhart, et al. (1996)
• Effect of tale dust inhalation on lung function — M. Kleinfeld, J. Messite, et al. (1965)
• Peritoneal mesothelioma presenting as an adnexal mass — R.A. Komorowski, D.H. Bobert (1975)
• Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial — S. Muruganandan, M. Azzopardi, et al. (2018)

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