Metastatic renal cell carcinoma mimicking pleural mesothelioma

Our plain-English summary of Metastatic renal cell carcinoma mimicking pleural mesothelioma, by D.R. Taylor, W. Page, D. Hughes, et al (Thorax, 1987).

The study

• Authors: D.R. Taylor, W. Page, D. Hughes, G. Varghese
• Journal: Thorax
• Published: 1987;42(11):901-2
• Type of article: Case report
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

The authors, from the Departments of Medicine and Pathology at The Queen's University of Belfast, reported a case of renal cell carcinoma that spread to the pleura and mimicked pleural mesothelioma. A 67 year old man had a six week history of dry cough, increasing breathlessness and left sided pleuritic chest pain. He had smoked 40 pack years and had been exposed to asbestos 25 years earlier while working as a boiler engineer. He had a left pleural effusion and a 6 cm mass in the left upper abdomen. Cytology of the pleural fluid showed no malignant cells. Computed tomography suggested mesothelioma or metastatic disease, with no pleural plaques. Abdominal scans showed a solid mass typical of renal cell carcinoma. Because of the asbestos history and the radiological appearances, mesothelioma was the clinical diagnosis, and the abdominal mass was thought to be a benign cyst. He died in respiratory failure after about four months. At necropsy, tumour filled the left pleural space and had grown along the track of a chest drain. The tumour looked like mesothelioma to the naked eye. However, histology and immunocytochemistry showed renal cell carcinoma and excluded mesothelioma. The right lung showed asbestos fibres and early asbestosis. The authors stated that whether asbestos was a cause in this case could not be established. They said the case is a reminder that asbestos is a possible cause of some non-respiratory tract tumours.

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 article was a case report about one patient, a 67-year-old man with a dry cough, increasing breathlessness and left-sided chest pain. He had smoked 40 pack years and had been exposed to asbestos 25 years earlier while working as a boiler engineer. He had fluid around the left lung. Tests on the fluid found no cancer cells. Scans suggested mesothelioma or cancer spread from elsewhere, and no pleural plaques were seen. Because of his asbestos history and the early scans, mesothelioma was the doctors' initial clinical diagnosis. He stayed stable for four months, then got worse and died of respiratory failure. At autopsy the tumour in the left chest looked the same as pleural mesothelioma. Tissue tests showed it was kidney cancer (renal cell carcinoma) spread from the left kidney, and ruled out mesothelioma. The right lung showed asbestos fibres and changes diagnostic of early asbestosis. The authors concluded that whether asbestos exposure played a part in causing this cancer could not be established. They added that the case was a reminder that asbestos is a possible cause of some tumours outside the respiratory tract.

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
• Who was studied: One 67-year-old man, reported by doctors from the Departments of Medicine and Pathology, The Queen's University of Belfast
• Exposure: Asbestos exposure 25 years earlier while working as a boiler engineer (fiber type not stated); he was also a lifelong smoker of 40 pack years
• Main results:
  • Tests on the fluid drained from around the patient's left lung did not find cancer cells
  • Scans of the chest and abdomen suggested mesothelioma or metastatic disease; no pleural plaques were identified
  • Because of the asbestos history and the initial scan appearances, mesothelioma had been the clinical diagnosis while the patient was alive
  • The patient remained stable for four months, then deteriorated and died in respiratory failure
  • At autopsy, the tumour filling the left pleural space looked indistinguishable from pleural mesothelioma to the naked eye
  • Tissue staining (immunocytochemical) tests confirmed the tumour was renal in origin and excluded mesothelioma
  • The tumour had spread along the track of the earlier chest drain, ending in a 4 cm lump under the skin
  • Asbestos fibres, mild fibrosis and alveolar wall thickening, diagnostic of early asbestosis, were found under the pleura of the right lung
  • A large renal cell carcinoma arising from the left kidney was confirmed at autopsy
• The authors' conclusion: The authors concluded that whether asbestos exposure was of causal significance in this case cannot be established, but that the case is a reminder that asbestos is a possible cause of some non-respiratory tract tumours
• Limitations the authors state:
  • The authors stated that whether asbestos exposure caused the cancer in this patient cannot be established

Topics

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

Medical terms in this study, explained in our Lexicon: Carcinoma, Pleural Mesothelioma, Pathology, Pleura, Pleuritic Chest Pain, Pleural Effusion, Cytology, Mesothelioma.

Related studies

• Value of PAX8, PAX2, napsin A, carbonic anhydrase IX, and claudin-4 immunostaining in distinguishing pleural epithelioid mesothelioma from metastatic renal cell carcinoma — N.G. Ordóñez (2013)
• The value of 'mesothelium-associated' antibodies in distinguishing between metastatic renal cell carcinomas and mesotheliomas — M. Osborn, N. Pelling, et al. (2002)
• Carbonic anhydrase IX is expressed in mesothelioma and metastatic clear cell renal cell carcinoma of the lung — M.L. Ramsey, B.J. Yuh, et al. (2012)
• A comparative immunohistochemical study of malignant mesothelioma and renal cell carcinoma: the diagnostic utility of Leu-M1, Ber EP4, Tamm-Horsfall protein and thrombomodulin — R.L. Attanoos, H. Goddard, et al. (1995)
• Cystic renal cell carcinoma: arose as a simple cyst, recurred repeatedly as a multicystic mass and finally presented as a solid mass — Y. Shishikura, M. Furusato, et al. (1998)
• The epidemiology of renal cell carcinoma — L. Lipworth, R.E. Tarone, et al. (2006)

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