Multiple primary hepatic malignant mesotheliomas mimicking cystadenocarcinomas on enhanced CT and FDG PET/CT

Our plain-English summary of Multiple primary hepatic malignant mesotheliomas mimicking cystadenocarcinomas on enhanced CT and FDG PET/CT, by A. Dong, H. Dong, C. Zuo (Clinical Nuclear Medicine, 2014).

The study

• Authors: A. Dong, H. Dong, C. Zuo
• Journal: Clinical Nuclear Medicine
• Published: 2014;39(7):619-22
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 50-year-old woman presented with upper abdominal pain for 2 months. Abdominal enhanced CT showed multiple hypodense cystic tumors in the liver with heterogeneous enhanced septations. FDG PET/CT showed hypermetabolic peripheral regions and internal septations of the tumors with SUVmax of 6.3. Multiple hepatic cystadenocarcinomas were suspected. The patient underwent resection of the tumors. Epithelial mesothelioma was confirmed by pathology. This case indicates primary hepatic mesothelioma should be added to the differential diagnosis of FDG-avid malignant hepatic tumors.

In plain English

This case report, published as an "Interesting Image" item, described a 50-year-old woman with upper abdominal pain for 2 months. The article stated that she had no history of asbestos exposure. Blood levels of alpha-fetoprotein, carcinoembryonic antigen and carbohydrate antigen 19-9 were normal, and tests for viral hepatitis were negative. CT scans showed multiple complex lesions in the liver with internal dividing walls (septations) that enhanced progressively with contrast. An FDG PET/CT scan showed an enlarged liver with multiple lesions taking up the tracer strongly at their edges and septations, with a maximum standardized uptake value (SUVmax) of 6.3. From these images, multiple hepatic cystadenocarcinomas were suspected. After the tumors were surgically removed, microscopic examination and staining were consistent with malignant mesothelioma of epithelial type arising in the liver. The authors stated that FDG PET/CT findings of primary hepatic mesothelioma had not been reported before, and concluded that it should be added to the list of possible diagnoses for FDG-avid malignant liver tumors.

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 (published as an 'Interesting Image' item)
• Who was studied: One 50-year-old woman with upper abdominal pain for 2 months; the authors were from hospitals of the Second Military Medical University, Shanghai, China
• Exposure: The article states the patient had no history of asbestos exposure; no fiber type or occupational exposure is described
• Main results:
  • Serum alpha-fetoprotein, carcinoembryonic antigen and carbohydrate antigen 19-9 levels were normal, and a viral hepatitis workup was negative
  • Unenhanced and enhanced CT showed multiple complex solid lesions in the liver with progressively enhanced septations
  • FDG PET/CT showed hepatomegaly with multiple hypermetabolic lesions, SUVmax 6.3, with hypermetabolic peripheral regions and internal septations
  • Based on the imaging, multiple hepatic cystadenocarcinomas were suspected
  • After resection, histopathology and immunohistochemical staining (positive for vimentin, cytokeratin 19 and calretinin) were consistent with malignant mesothelioma of epithelial type
  • The authors stated that FDG PET/CT findings of primary hepatic mesothelioma had not been reported before
• The authors' conclusion: The authors concluded that hepatic malignant mesothelioma should be added to the differential diagnosis of FDG-avid malignant hepatic tumors

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma, Pathology, Differential Diagnosis.

Related studies

• Pseudomesotheliomatous lung cancer mimicking mesothelioma on ¹⁸F-FDG PET/CT images: report of 2 cases — T. Nakamori, S. Kosuda, et al. (2013)
• A case of primary pericardial mesothelioma detected by 18F-FDG PET/CT — F. Aga, Y. Yamamoto, et al. (2012)
• Sarcomatoid carcinoma (carcinosarcoma) of the lung mimics malignant pleural mesothelioma on 18F-FDG PET/CT: a report of 2 cases — A. Ciarallo, W. Makis, et al. (2012)
• High performance of F-fluorodeoxyglucose positron emission tomography and contrast-enhanced CT in a rapid outpatient diagnostic program for patients with suspected lung cancer — P. Brocken, H.F. van der Heijden, et al. (2014)
• The association of 18F-FDG PET/CT parameters with survival in malignant pleural mesothelioma — A. Klabatsa, S. Chicklore, et al. (2014)
• Current evidence base of FDG-PET/CT imaging in the clinical management of malignant pleural mesothelioma: emerging significance of image segmentation and global disease assessment — S. Basu, B. Saboury, et al. (2011)

Browse more research in Clinical Nuclear Medicine, or return to medical research.