Malignant peritoneal mesothelioma with lower extremity metastasis: PET/CT imaging

Our plain-English summary of Malignant peritoneal mesothelioma with lower extremity metastasis: PET/CT imaging, by B.B. Le, B.D. Nguyen (Clinical Nuclear Medicine, 2015).

The study

• Authors: B.B. Le, B.D. Nguyen
• Journal: Clinical Nuclear Medicine
• Published: 2015;40(1):e68-70
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant peritoneal mesothelioma is usually confined to the abdomen and pelvis. Extra-abdominal and extrapelvic dissemination is very uncommon mostly at advanced stages of the disease. This rare clinical event may be related to contiguous spread through connecting pathways linking the abdomen and pelvis to the thorax and proximal lower extremity. The authors present a case of advanced malignant peritoneal mesothelioma with contiguous dissemination to the right thigh and proximal leg documented and monitored by F-FDG PET/CT imaging.

In plain English

This article was a case report, published as a short imaging feature by the Department of Radiology at Mayo Clinic in Scottsdale, Arizona. It described one patient, a 71-year-old woman who came in with sudden swelling of her right thigh and later had nausea, vomiting and diarrhea. Her history included treated breast cancer and hepatocellular carcinoma, and the authors recorded a lack of exposure to asbestos. CT showed swollen, infiltrating tissue in the muscles and soft tissues of the right abdomen, pelvis and upper right thigh. Surgery found widespread malignant peritoneal mesothelioma of epithelial type. PET/CT showed abnormal tracer uptake (SUV 4.7 to 7.4) in the biopsy-proven tumor, reaching from the abdominal and pelvic walls to the right thigh and upper right calf. She was not a surgical candidate. After 4 cycles of carboplatin and pemetrexed, PET/CT showed partial improvement. The authors wrote that skin and muscle involvement of the lower extremity had not been reported. They suggested the spread could have come through pathways connecting the pelvis and thigh, and they described PET/CT as a valuable tool for staging and monitoring this disease.

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, imaging feature)
• Who was studied: One 71-year-old woman seen at Mayo Clinic, Scottsdale, Arizona, with a history of treated breast cancer and hepatocellular carcinoma
• Exposure: No asbestos exposure; the authors recorded a lack of exposure to asbestos in her history
• Main results:
  • At exploratory laparotomy the patient had widespread mesothelioma of epithelial type involving the mesentery of the terminal ileum, omentum, right colic gutter and right anterior abdominal wall
  • In this patient, PET/CT showed abnormal uptake (SUV 4.7 to 7.4) in the biopsy-proven mesothelioma, including the abdominal and pelvic wall muscles, perineum, right labia, right thigh and the superficial tissues of the right medial upper calf
  • The patient was not a surgical candidate because the disease was widespread. After 4 cycles of carboplatin and pemetrexed, PET/CT showed partial improvement, with decreased tracer uptake in the abdomen, pelvis and right lower extremity
• The authors' conclusion: The authors stated that skin and muscle involvement of the lower extremity had not been reported. They suggested the spread to the thigh and leg could be contiguous, through pathways between the pelvis and proximal thigh, and they described PET/CT as a valuable imaging tool for staging and post-treatment monitoring of malignant peritoneal mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Metastasis, Thorax.

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