Mesothelioma of childhood

Our plain-English summary of Mesothelioma of childhood, by A.E. Fraire, S. Cooper, S.D. Greenberg, et al (Cancer, 1988).

The study

• Authors: A.E. Fraire, S. Cooper, S.D. Greenberg, P. Buffler, C. Langston
• Journal: Cancer
• Published: 1988;62(4):838-47
• Type of article: Review
• Cited by: 89 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000218).

Abstract

Malignant mesothelioma (MM) of childhood is a rare but important neoplasm. Eighty children with a previous diagnosis of MM were identified. Four of the 80 children had exposure to known risk factors (two had history of exposure to asbestos, one had received radiation therapy, and one had been exposed in utero to isoniazid). Tissue slides were available for independent and joint review by a panel of three pathologists in 22 of the cases. Ten were accepted as MM, nine were reclassified as other malignancies, and three were considered tumors of uncertain nature. Six of the ten children with MM were boys, and four were girls. Eight had pleural tumors, and two had peritoneal tumors. Four died at 7, 8, 18, and 48 months after diagnosis; three remained alive at 19, 20, and 59 months; and three had no follow-up. This review suggests that MM of childhood is a valid entity with a grave prognosis. The tissue diagnosis is difficult and is best made by a panel of pathologists. The available evidence does not support a causal relationship between MM and asbestos, radiation, or isoniazid.

In plain English

This was a review of 80 cases of malignant mesothelioma diagnosed in people aged up to 19 years, 38 from the United States and 42 from 15 other countries, drawn from published reports, registries and other sources. Of these, 54 tumors were pleural, 20 peritoneal and 6 pericardial. Four children had a known risk factor, and two had a history of possible exposure to asbestos. Three pathologists reviewed slides for 22 cases, first separately and then together. The panel accepted 10 as mesothelioma, reclassified 9 as other tumors and judged 3 uncertain. Of the 10 accepted cases, 8 were pleural and 2 peritoneal. Four of these children died at 7, 8, 18 and 46 months after diagnosis, three were alive at 19, 20 and 59 months, and three had unknown outcomes. One accepted case was a 17-year-old girl with possible asbestos exposure in a school environment. The authors concluded that the available data do not support a clear causal association between childhood mesothelioma and asbestos, radiation or isoniazid.

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: Review of published and unpublished case reports of childhood mesothelioma (a case series), with slides re-examined by a panel of three pathologists
• Who was studied: 80 children and young people aged up to 19 years who had previously been diagnosed with mesothelioma of the pleura, peritoneum or pericardium: 38 from the United States and 42 from 15 other countries. Slides were reviewed for 22 of them.
• Exposure: Known risk factors were assessed: asbestos, radiation therapy and isoniazid taken by the mother during pregnancy. Two of the 80 children had a history of possible asbestos exposure. One was the daughter of a worker at a Pennsylvania insulation plant handling chrysotile and amosite asbestos. The other had possible exposure in a school environment.
• Main results:
  • Of all 80 cases, 47 (58.7%) were boys and 33 (41.3%) were girls
  • Of all 80 cases, 54 (67.5%) were pleural; the article also lists 20 peritoneal and 6 pericardial cases
  • Risk factors were identified in 4 of the 80 children
  • Of the 22 cases whose slides were reviewed, 10 were accepted as mesothelioma, 9 were reclassified as other tumors and 3 were of uncertain origin
  • Of the 10 accepted cases, 8 tumors were pleural, 2 were peritoneal and none were pericardial
  • Of the 10 accepted cases, 4 children died at 7, 8, 18 and 46 months after diagnosis
  • Of the 10 accepted cases, 3 were alive at 19, 20 and 59 months after diagnosis, and the outcome was unknown for 3
  • Among the 10 accepted cases, 2 had risk factors and none had exposure to isoniazid
  • One accepted case was a 17-year-old girl with possible asbestos exposure in a school environment, who had a diffuse malignant pleural mesothelioma
  • The 3-year-old girl with pleural mesothelioma was the daughter of a ceramics engineer at an insulation plant handling chrysotile and amosite asbestos; the panel did not review her slides
  • Agreement between the pathologists was limited: only one of three observer pairs reached a kappa of 0.40, which was statistically significant (P < 0.01)
  • Deaths were 7/9 among reclassified cases, 2/3 among doubtful cases and 4/10 among accepted cases; the difference was not statistically significant (P = 0.24)
• The authors' conclusion: The authors concluded that childhood mesothelioma is a valid pathologic entity, and that the available data do not support a clear causal association between childhood mesothelioma and asbestos exposure, radiation or isoniazid.
• Limitations the authors state:
  • Only a few of the reviewed cases were evaluated by histochemistry or electron microscopy
  • The panel did not review slides for the case with possible asbestos exposure through the father's work
  • Slides for the isoniazid-exposed case could not be obtained
  • No data on dose or latency of exposure are available for childhood cases

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: Mesothelioma, Malignant Mesothelioma, Neoplasm, Prognosis.

Related studies

• Spectrum of peritoneal mesothelioma in childhood: clinical and histopathologic features, including DNA cytometry — F.K. Niggli, T.J. Gray, et al. (1994)
• Pulmonary abnormalities as a result of exposure to Libby amphibole during childhood and adolescence-The Pre-Adult Latency Study (PALS) — J. Szeinuk, C.W. Noonan, et al. (2017)
• Parental occupational exposure and risk of childhood central nervous system tumors: a pooled analysis of case-control studies from Germany, France, and the UK — C. Huoi, A. Olsson, et al. (2014)
• Childhood exposure to Libby amphibole during outdoor activities — P.H. Ryan, G.K. LeMasters, et al. (2015)
• Childhood exposure to Libby amphibole asbestos and respiratory health in young adults — P.H. Ryan, C.H. Rice, et al. (2017)
• Malignant intraperitoneal neoplasms of childhood — C.J. Chung, V. Bui, et al. (1998)

Browse more research in Cancer, or return to medical research.