Malignant pleural mesothelioma in a kidney transplant recipient

Our plain-English summary of Malignant pleural mesothelioma in a kidney transplant recipient, by W. Traipipitsiriwat, C. Songsomboon, D. Junhasavasdikul, et al (Thoracic Cancer, 2021).

The study

• Authors: W. Traipipitsiriwat, C. Songsomboon, D. Junhasavasdikul, V. Boonsarngsuk, W. Klaisuban
• Journal: Thoracic Cancer
• Published: 2021;12(8):1260-1263
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Post-transplantation malignancy is one of the most common complication-related mortality in transplant recipients. Here, we report the case of a kidney transplant patient for 2 years with malignant pleural effusion that was subsequently diagnosed as malignant pleural mesothelioma.

© 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

In plain English

This case report from Ramathibodi Hospital in Bangkok, Thailand, described one 53-year-old man who had received a living donor kidney transplant from his daughter in September 2018. In August 2020 he came to the hospital with a two-month history of worsening breathlessness and right-sided chest pain. He had worked as a police officer, and neither he nor his family had any history of prior asbestos exposure. A sample of the fluid around his right lung showed only inflammatory cells and reactive mesothelial cells. A biopsy of the pleura (the lining around the lung) showed epithelioid mesothelioma. Scans showed the tumor had spread to the right chest wall, the mediastinum and the peritoneum, and it was staged as T4N2M1, stage IV. He was treated with carboplatin and pemetrexed chemotherapy. After four cycles, scans showed stable disease. The authors did not test for simian virus 40 (SV40), a virus they suggested might play a role. They wrote that more evidence is needed on this idea. The authors concluded that doctors should keep this rare disease in mind even when there is no history of asbestos exposure.

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 (a single patient)
• Who was studied: One man who had received a living donor kidney transplant from his daughter in September 2018, for end-stage kidney disease caused by diabetes. He was treated at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
• Exposure: No asbestos exposure was reported. The patient had worked as a police officer, and neither he nor his family members had any history of prior asbestos exposure.
• Main results:
  • In August 2020 the patient, a 53-year-old man, came to the hospital with a 2-month history of worsening breathlessness and right-sided chest pain.
  • Testing of the patient's pleural fluid showed only inflammatory cells and reactive mesothelial cells.
  • In the patient's pleural biopsy, the tumor cells were positive for the mesothelial markers calretinin, D2-40, CK5/6 and WT1. This was consistent with epithelioid mesothelioma.
  • In the patient, the tumor had invaded the visceral and parietal pleura, the right chest wall, the mediastinum and the peritoneum.
  • The patient's tumor was staged as T4N2M1, stage IV.
  • The patient was treated with systemic chemotherapy using carboplatin and pemetrexed.
  • In the patient, after four cycles of chemotherapy, follow-up imaging showed stable disease.
• The authors' conclusion: The authors concluded that, although the disease is rare, physicians should keep the possibility of malignant pleural mesothelioma in mind even when there is no history of asbestos exposure.
• Limitations the authors state:
  • Because specific tests were lacking, the authors did not investigate whether simian virus 40 (SV40) was involved in this patient.
  • The authors stated that their suggestion of a link between SV40 and early-onset mesothelioma after transplant needs more evidence before a conclusion can be made.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Pleural Effusion.

Related studies

• Risk of de novo cancers after transplantation: results from a cohort of 7217 kidney transplant recipients, Italy 1997-2009 — P. Piselli, D. Serraino, et al. (2013)
• Malignant Epithelioid Mesothelioma of the Tunica Vaginalis Testis Presenting as Hydrocele in a Kidney Transplant Recipient — B.M. Behers, C.W. Guske, et al. (2024)
• De Novo Solid Tumors After Kidney Transplantation: Is It Time for a Patient-Tailored Risk Assessment? Experience From a Single Center — A. Rossetto, P. Tulissi, et al. (2015)
• Sarcomas in organ allograft recipients — I. Penn (1995)
• Decreased asbestos-induced lung inflammation and fibrosis after radiation and bone marrow transplant — J. Levis, R. Loi, et al. (2008)
• Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma — J.A. Bishop, R. Sharma, et al. (2010)

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