Metastasis of pleural mesothelioma presenting as bleeding colonic polyp

Our plain-English summary of Metastasis of pleural mesothelioma presenting as bleeding colonic polyp, by S. Sibio, P. Sammartino, F. Accarpio, et al (The Annals of Thoracic Surgery, 2011).

The study

• Authors: S. Sibio, P. Sammartino, F. Accarpio, D. Biacchi, T. Cornali, M. Cardi, F. Iafrate, A. Di Giorgio
• Journal: The Annals of Thoracic Surgery
• Published: 2011;92(5):1898-901
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report the case of a 72-year-old woman with metastatic malignant mesothelioma presenting as right colonic polyp. She was diagnosed with malignant pleural mesothelioma 2 years previously and underwent surgery, radiotherapy, and chemotherapy. After 2 years with a negative follow-up, she was admitted to the infectious disease department for malaria and severe anaemia. A computed tomographic scan and a colonoscopy showed a huge bleeding polypoid lesion in the right colon diagnosed as adenocarcinoma. She underwent a right hemicolectomy; a pathologic examination found neoplastic cell population positive to anti-cytokeratin7, anti-calretinin, anti-vimentin, and negative for anti-cytokeratin 20, MOC-31, and thyroid transcription factor 1, providing a diagnosis of metastatic mesothelioma.

Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

In plain English

This case report described one 72-year-old white woman living in South Africa who had been diagnosed with pleural mesothelioma in 2005. She had been treated with chest surgery that removed part of the chest wall and diaphragm, followed by four courses of chemotherapy with cisplatin and Alimta. The authors stated that she had no previous history of asbestos exposure. While being treated for malaria, she was found to have severe anemia (hemoglobin 7.2 g/dL). A CT scan showed a 4 cm by 4 cm polyp-like growth in the colon near the ileocecal valve, with no evidence that the disease had come back in the chest. Colonoscopy showed that the growth was bleeding. Biopsies were first read as colon adenocarcinoma, and the right side of her colon was removed along with 22 lymph nodes. Microscope and staining tests then identified the growth as metastatic malignant pleural mesothelioma of the epithelial type. She was reported alive and disease-free after 4 years of follow-up. The authors concluded that metastatic malignant mesothelioma should be considered when diagnosing tumors of the colon.

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)
• Who was studied: One 72-year-old white woman living in South Africa, admitted to an infectious disease department with malaria and severe anemia; treated in Rome, Italy
• Exposure: The authors reported that the patient had no previous history of asbestos exposure; no fiber type or occupational exposure is described
• Main results:
  • The patient's history included a diagnosis of pleural mesothelioma in 2005, treated by left thoracotomy with chest wall and diaphragm resection
  • Surgery was followed by four courses of chemotherapy with cisplatin and Alimta
  • While recovering from malaria, the patient had severe anemia with hemoglobin of 7.2 g/dL
  • CT showed a polypoid lesion measuring 4 cm by 4 cm near the ileocecal valve
  • CT also showed some local and ileocolic lymph node enlargement, with no evidence that the disease had returned in the chest
  • Colonoscopy confirmed a bleeding polypoid lesion in the right colon
  • Biopsies of the colon lesion were initially diagnosed as colon adenocarcinoma
  • The patient underwent removal of the right colon with a regional lymph node dissection in which 22 lymph nodes were taken
  • On immunohistochemistry, the tumor cells stained for calretinin, cytokeratin 5/6 and vimentin (among other markers)
  • The tumor cells did not stain for cytokeratin 20 or MOC-31 (among other markers)
  • The colon lesion was finally diagnosed as metastatic malignant pleural mesothelioma of the epithelial type
  • The patient was reported alive and disease-free after 4 years of follow-up
• The authors' conclusion: The authors concluded that metastatic malignant mesothelioma should be considered in the differential diagnosis of colon tumors, and that a careful clinical history should be taken so that confirmatory studies are done

Topics

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

Medical terms in this study, explained in our Lexicon: Metastasis, Pleural Mesothelioma, Malignant Mesothelioma, Chemotherapy, Adenocarcinoma, Calretinin, MOC-31, Mesothelioma.

Related studies

• Metastatic malignant mesothelioma presenting as colonic polyps — A.V. Masangkay, M. Susin, et al. (1997)
• What caused gastrointestinal bleeding in a woman with a history of pleural mesothelioma? Metastatic diffuse epithelioid mesothelioma — F. Iafrate, S. Sibio, et al. (2010)
• Colonic invasion induced by malignant peritoneal mesothelioma — S.B. Cao, S. Jin, et al. (2014)
• Benign multicystic mesothelioma with concurrent colonic adenocarcinoma: a report of two cases — A. Husain, M. Ozdemirli (2012)
• American Cancer Society plans for a long-range study of colonic and rectal cancer — E.C. Hammond (1970)
• Colonic invasion of malignant peritoneal mesothelioma — C.C. Chan, H. Isomoto, et al. (2010)

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