Nine-year survival in a case of untreated peritoneal mesothelioma

Our plain-English summary of Nine-year survival in a case of untreated peritoneal mesothelioma, by P.E. Norman, D. Whitaker (The Medical Journal of Australia, 1989).

The study

• Authors: P.E. Norman, D. Whitaker
• Journal: The Medical Journal of Australia
• Published: 1989;150(1):43-4
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000138).

Abstract

A patient with malignant mesothelioma of the peritoneum, which has been untreated except for regular paracentesis for effusions, has remained alive and generally-well for nine years. The poor prognosis that usually is ascribed to this disease may not be applicable universally.

In plain English

This article is a case report of one man with malignant peritoneal mesothelioma, a cancer of the abdominal lining. The 73-year-old man came to hospital on November 13, 1979, with abdominal pain and swelling. Surgery found widespread cancer in the abdomen with fluid build-up; a biopsy was taken but the tumour was not removed. It was first thought to be cancer that had spread from elsewhere, but it was diagnosed as malignant mesothelioma from tissue, fluid and electron microscope tests. He received palliative care, and for nine years his only treatment was repeated draining of the abdominal fluid, by then weekly, about 5 L each time. Despite ongoing fluid and slowly growing abdominal masses, he was in good health and living independently. He had no known asbestos exposure but had worked with uranium in 1960. The authors reviewed 11 other peritoneal mesothelioma cases in Western Australia and found an average survival of only three months from diagnosis. The authors concluded that untreated peritoneal mesothelioma does not necessarily lead to early death.

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 73-year-old man who presented to hospital on November 13, 1979, with abdominal pain and distension; the authors are based at The Queen Elizabeth II Medical Centre, Nedlands, Western Australia
• Exposure: No known exposure to asbestos; the patient worked with uranium in 1960. No fiber type is reported.
• Main results:
  • At laparotomy the patient had extensive, disseminated peritoneal malignancy with ascites. A biopsy was taken but no attempt was made to remove the tumour, which was initially regarded as a metastatic adenocarcinoma.
  • Malignant mesothelioma was diagnosed from examination of the omental biopsy, cytology of the recurrent effusion, and ultrastructural (electron microscope) assessment of the effusion cells.
  • Over nine years the only treatment was repeated paracentesis (draining of abdominal fluid), by then performed once a week with about 5 L drained each time.
  • Despite continuing ascites and gradually enlarging abdominal masses, the patient was reported to enjoy good health and to live independently at home.
  • Repeated cytological examination of the drained fluid showed the characteristic features of malignant mesothelioma on each occasion.
  • From case-notes or the WA Cancer Registry, the authors reviewed 11 other cases of malignant peritoneal mesothelioma in Western Australia and found an average survival of only three months from diagnosis.
• The authors' conclusion: The authors concluded that peritoneal mesothelioma left untreated does not necessarily lead to early death, and that the poor prognosis usually given for this disease may not apply universally.

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Malignant Mesothelioma, Peritoneum, paracentesis, Prognosis.

Related studies

• Peritoneal Mesothelioma with Residential Asbestos Exposure. Report of a Case with Long Survival (Seventeen Years) Analyzed by Cgh-Array — G. Serio, F. Pezzuto, et al. (2017)
• Epidemiology and outcome of peritoneal and pleural mesothelioma subtypes in Norway. A 20 year nation-wide study — O.T. Brustugun, Y. Nilssen, et al. (2021)
• Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma — G.H. Eltabbakh, M.S. Piver, et al. (1999)
• Malignant Peritoneal Mesothelioma: National Practice Patterns, Outcomes, and Predictors of Survival — V. Verma, R.L. Sleightholm, et al. (2018)
• Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma — H. Kaya, C. Sezgı, et al. (2014)
• A novel nomogram for peritoneal mesothelioma predicts survival — N.P. Schaub, M. Alimchandani, et al. (2013)

Browse more research in The Medical Journal of Australia, or return to medical research.