Muscle Involvement in Long-term Malignant Pleural Mesothelioma

Our plain-English summary of Muscle Involvement in Long-term Malignant Pleural Mesothelioma, by P. Cruz Castellanos, T. González Merino, J. de Castro Carpeño (Archivos de Bronconeumología, 2018).

The study

• Authors: P. Cruz Castellanos, T. González Merino, J. de Castro Carpeño
• Journal: Archivos de Bronconeumología
• Published: 2018;54(5):284-285
• Type of article: Case report
• Language: Spanish
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a scientific letter, in Spanish, about one patient treated in the medical oncology department of Hospital Universitario La Paz, Madrid. The patient was 60, an active smoker (40 pack-years), and had worked in construction. The letter does not say whether the patient was exposed to asbestos. In 2011 the patient went to the emergency department with atypical chest pain and a large pleural effusion. A biopsy confirmed malignant pleural mesothelioma, judged too extensive to remove. After 4 cycles of platinum-based chemotherapy with pemetrexed the tumor partly shrank, and pemetrexed alone was continued. The disease stayed stable for two and a half years. The patient then developed pain and stony hardening in the left thigh. Imaging showed a soft-tissue lesion through the whole thigh reaching the buttock, and a biopsy confirmed a mesothelioma metastasis. Local radiotherapy to the muscle lesion was proposed, and the same chemotherapy was continued, with disease control for 12 more months. The authors called the course atypical: 36 months' survival against an average of about 12 months, and an exceptionally rare spread to muscle.

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 (scientific letter to the editor describing one patient)
• Who was studied: One 60-year-old patient, an active smoker (40 pack-years) who had worked in construction, first seen in 2011 and treated at Hospital Universitario La Paz, Madrid, Spain
• Exposure: Occupation in construction and active smoking (40 pack-years). The letter does not report asbestos exposure for this patient. Asbestos is mentioned only as a general, classically associated risk factor for mesothelioma, citing other sources.
• Main results:
  • A pleural biopsy guided by video-assisted thoracoscopy confirmed malignant pleural mesothelioma. Because of its extent it was considered unresectable.
  • After 4 cycles of a platinum doublet with pemetrexed there was a partial response by RECIST criteria, with little toxicity.
  • On pemetrexed maintenance therapy the disease remained stable for 2 and a half years.
  • MRI of the painful left thigh showed a soft-tissue lesion involving the whole thigh and extending to the buttock.
  • An ultrasound-guided biopsy confirmed a metastasis of malignant mesothelioma in the thigh.
  • Local radiotherapy to the muscle lesion was proposed. The letter does not explicitly say it was given.
  • The same systemic treatment was continued, with disease control for 12 more months.
  • The patient's survival with treatment was 36 months. The authors put average survival at about 12 months.
• The authors' conclusion: The authors concluded that the case illustrates an atypical course of pleural mesothelioma, with long survival on treatment and an exceptionally rare spread to muscle. They suggested that long-standing tumors may spread atypically to 'sanctuary organs'. For patients with few metastases, they described continuing systemic treatment plus local treatment as a valid option.

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: Pleural Mesothelioma.

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