Mesothelioma of the peritoneum; a case report in which the ascitic fluid contained hyaluronic acid

Our plain-English summary of Mesothelioma of the peritoneum; a case report in which the ascitic fluid contained hyaluronic acid, by S. Dvoskin (Annals of Internal Medicine, 1954).

The study

• Author: S. Dvoskin
• Journal: Annals of Internal Medicine
• Published: 1954;40(4):809-11
• Cited by: 18 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of mesothelioma of the peritoneum is reported in which a viscous ascitic fluid was found to contain hyaluronic acid. This finding early in the patient's course led to the suspicion of the diagnosis of mesothelioma, later confirmed by the autopsy findings.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article is a case report about a single patient with mesothelioma of the peritoneum, the lining of the abdomen. The article does not mention asbestos or any other exposure. A 27-year-old woman was admitted to the United States Army Hospital at Fort McClellan, Alabama, in May 1952 for hernia repair. Soon afterward her abdomen filled with fluid. At exploratory surgery the peritoneum was covered with nodules, but the first biopsy report described chronic inflammation. Fluid was drained six times, about 6,000 c.c. each time. It was thick and mucus-like, and adding the enzyme hyaluronidase made it markedly less thick. Laboratory analysis found 0.103 per cent sodium hyaluronate, a form of hyaluronic acid. She died on June 12, 1952, about one month after her symptoms began. At autopsy, tumor covered the surfaces of nearly all abdominal and pelvic organs and was classified as a malignant diffuse tubular mesothelioma, undifferentiated. The author reported that finding hyaluronic acid led to the suspicion of mesothelioma. The author also stated that the significance of this finding remains to be determined, because no survey of fluids from other causes had been reported.

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 (one patient)
• Who was studied: One 27-year-old white woman treated at the United States Army Hospital, Fort McClellan, Alabama, from May to June 1952
• Main results:
  • The initial pathology report on the ovary and omentum biopsies was chronic inflammation
  • Each of six drainages of the abdomen produced about 6,000 c.c. of thick, mucus-like brownish fluid
  • Papanicolaou smears of the fluid were reported to show mesothelial cells
  • Adding hyaluronidase to the fluid in the laboratory markedly reduced its thickness
  • The patient's abdominal fluid contained 0.103 per cent sodium hyaluronate
  • The patient died on June 12, 1952, about one month after symptoms began
  • At autopsy the pleural cavities were free of fluid
  • The autopsy tumor was classified as a malignant diffuse tubular mesothelioma, undifferentiated
• The authors' conclusion: The author concluded that finding hyaluronic acid in the fluid early in the illness led to the suspicion of mesothelioma, which was later confirmed at autopsy. The author also suggested that this finding could be regarded as suggestive biochemical evidence of the mesenchymal origin of such tumors.
• Limitations the authors state:
  • The significance of the hyaluronic acid finding is uncertain because no survey of hyaluronic acid in abdominal fluid from other causes had been reported

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneum, Hyaluronic Acid, Autopsy.

Related studies

• Recombinant human endostatin (endostar) decreased recurrent ascites, pleural fluid and ascitic VEGF in a case of advanced mesothelioma — X. Chen, Y. Liu, et al. (2012)
• Hyaluronic acid in the pleural fluid of patients with malignant pleural mesothelioma — N. Fujimoto, K. Gemba, et al. (2013)
• Utility of hyaluronic acid in pleural fluid for differential diagnosis of pleural effusions: likelihood ratios for malignant mesothelioma — S. Atagi, M. Ogawara, et al. (1997)
• Histochemical demonstration of hyaluronic acid in pleural mesotheliomas — J.C. Wagner, D.E. Munday, et al. (1962)
• Clinical significance of the immunometric measurements of hyaluronic acid — E.H. Cooper, B.J. Rathbone (1990)
• Pleural effusion hyaluronic acid as a prognostic marker in pleural malignant mesothelioma — J. Creaney, I.M. Dick, et al. (2013)

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