Meningeal and brain metastases in primary malignant pericardial mesothelioma

Our plain-English summary of Meningeal and brain metastases in primary malignant pericardial mesothelioma, by U. Bohn, J.L. Gonzalez, L.M. Martin, et al (Annals of Oncology, 1994).

The study

• Authors: U. Bohn, J.L. Gonzalez, L.M. Martin, A. Casado, E. Diaz-Rubio, P. Aragoncillo
• Journal: Annals of Oncology
• Published: 1994;5(7):660-1
• Type of article: Case report, Letter
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors reported a case of primary malignant pericardial mesothelioma, an uncommon tumour of which about 150 cases had been reported, with spread to the meninges and brain. The patient was a 51-year-old Spanish furrier and heavy smoker who developed weakness, weight loss (16 pounds in three months), cough and progressive breathlessness from December 1987. In February 1988 he was admitted in cardiac tamponade. CT showed extensive pericardial infiltration with pleural involvement, and bone studies showed multiple lytic metastases and marrow infiltration by mesothelial cells. A partial pericardiectomy confirmed malignant pericardial mesothelioma, and he received CYVADIC chemotherapy (cyclophosphamide, adriamycin, vincristine and dacarbazine). One month later he developed weakness of both legs, and spinal fluid cytology was positive for malignant mesothelial cells. Intrathecal cytarabine with steroids, given twice weekly for one month, did not clear these cells, and he died on 13 May 1988. At necropsy the heart was encased in tumour and the pleura was infiltrated. Malignant cells were found in the dura mater and in the leptomeninges of the brain stem and pons, with brain micrometastases, a 0.5 cm parietal nodule and metastases in several other organs. The authors stated that, to their knowledge, this was the first reported case with meningeal metastases diagnosed before and after death, and that brain metastases had not been described at necropsy. The report did not mention asbestos.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This letter was a case report from a Madrid hospital describing one patient with primary malignant pericardial mesothelioma, a cancer of the lining around the heart. The patient was a 51-year-old Spanish furrier and heavy smoker. The article does not mention asbestos. In February 1988 the patient was hospitalized with cardiac tamponade (fluid compressing the heart). Tests showed pericardial infiltration with pleural involvement and multiple bone metastases, and surgical tissue confirmed the diagnosis. After chemotherapy began, the patient developed leg weakness. Spinal fluid contained malignant mesothelial cells, which persisted despite chemotherapy given into the spinal fluid. The patient died on 13 May 1988. Autopsy found the heart encased in tumour and tumour in the membranes covering the brain and brain stem. It also found a 0.5 cm metastatic nodule on the subdural surface of the left parietal region, brain micrometastases, and spread to several other organs. The authors stated that, to their knowledge, this was the first reported case of this cancer with meningeal metastases diagnosed before and after death. They also stated that brain metastases from it had not been described at autopsy.

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 (letter)
• Who was studied: One patient, a 51-year-old Spanish furrier and heavy smoker, treated at Hospital Clinico Universitario San Carlos, Madrid. Symptoms began December 1987, admitted February 1988, died 13 May 1988.
• Exposure: The article reports no asbestos exposure and does not mention asbestos. The only background given is that the patient was a furrier and a heavy smoker.
• Main results:
  • The patient was admitted in February 1988 in cardiac tamponade. Investigations showed multiple lytic bone metastases.
  • The diagnosis was made on tissue from a partial pericardiectomy, performed three days after the pericardial fluid was drained.
  • One month after the first chemotherapy cycle (CYVADIC), the patient had leg weakness, and spinal fluid cytology was positive for malignant mesothelial cells.
  • Malignant cells persisted in the cerebrospinal fluid despite a month of twice-weekly intrathecal cytarabine plus steroids.
  • The patient died on 13 May 1988.
  • At autopsy the whole heart was encased in a tumour mass filling the pericardial space.
  • At autopsy there was a 0.5 cm metastatic nodule on the subdural surface of the left parietal region. Tumour also infiltrated the dura mater and the leptomeninges of the brain stem and pons.
  • Brain micrometastases were found.
  • Microscopy showed a diffuse mixed fibroepithelial malignant mesothelioma, and metastatic tumour was present in several other organs.
• The authors' conclusion: The authors stated that, to their knowledge, this was the first case report of primary malignant pericardial mesothelioma with meningeal metastases diagnosed before and after death. They also stated that the literature contains no description of brain metastases from this cancer at necropsy.

Topics

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

Medical terms in this study, explained in our Lexicon: Pericardial Mesothelioma, Cardiac Tamponade, Pericardial, Mesothelial Cells, Pericardiectomy, Chemotherapy, Fluid Cytology, Autopsy.

Related studies

• Malignant mesothelioma with brain metastases — J.A. Kaye, A.M. Wang, et al. (1986)
• Brain metastases in malignant pleural mesothelioma. Case report and review of the literature — K.S. Sridhar, A.M. Hussein, et al. (1989)
• Brain metastases in malignant pleural mesothelioma — T. Yamagishi, N. Fujimoto, et al. (2016)
• Response to chemotherapy of brain metastases from malignant pleural mesothelioma — M. Colleoni, G. Liessi, et al. (1996)
• Meningeal metastasis of a malignant peritoneal mesothelioma: A case report and literature review — Y. Jiang, Z. Mei, et al. (2019)
• Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors — S. Hendry, R. Salgado, et al. (2017)

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