Ovarian metastasis from malignant pleural mesothelioma

Our plain-English summary of Ovarian metastasis from malignant pleural mesothelioma, by G. Naldi, S. Bergomi, P. Visca, et al (Tumori, 2020).

The study

• Authors: G. Naldi, S. Bergomi, P. Visca, F.L. Cecere
• Journal: Tumori
• Published: 2020;106(6):NP49-NP51
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Malignant pleural mesothelioma (MPM) is a rare and aggressive disease of the pleura with a dismal prognosis. Distant metastases most commonly occur in the liver, spleen, and thyroid gland. To our knowledge, ovarian metastases have never been described.

Case Description: We describe a case of a woman with recurrent malignant pleural mesothelioma presenting a single ovarian metastasis, surgically resected.

Conclusions: This case report highlights the importance of using a complete staging protocol in patients with MPM to improve patient management. A whole-body computed tomography (CT) scan with contrast enhancement and possibly positron emission tomography-CT should be performed to identify any distant metastases before deciding on treatment strategy.

In plain English

This case report about one patient comes from the Regina Elena National Cancer Institute in Rome, Italy. A 68-year-old woman with no history of professional asbestos exposure had chest pain and a mass in the right chest. A biopsy showed epithelioid malignant pleural mesothelioma. Contrast CT showed no distant spread. She received six cycles of cisplatin plus pemetrexed, then pemetrexed alone. A later PET scan showed an active spot in the right lower pelvis. Ultrasound found a 34 by 20 by 16 mm solid mass on the right ovary. Both ovaries and part of the omentum were surgically removed. Tissue tests on the ovarian mass matched the chest biopsy, showing it was spread of the mesothelioma. Two months after surgery, CT showed no disease in the lower abdomen, but the chest tumor had progressed; she started gemcitabine. The authors stated that, to their knowledge, ovarian spread from this cancer had never been described. They concluded that doctors should consider spread outside the chest and use contrast CT, and possibly PET-CT, to look for distant spread before deciding treatment.

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 (one patient)
• Who was studied: one 68-year-old woman, reported by authors at the Regina Elena National Cancer Institute, Rome, Italy; dates of care not given
• Exposure: The article reports no history of professional (occupational) asbestos exposure; no other exposure information is given
• Main results:
  • A biopsy through the chest wall showed epithelioid malignant pleural mesothelioma
  • At diagnosis, no distant spread was seen on CT scan with contrast
  • The patient received six cycles of cisplatin plus pemetrexed, then maintenance pemetrexed alone
  • PET scan showed uptake in the right pleura (SUVmax 6.5) and a focal active spot in the right lower pelvis of probable ovarian origin (SUVmax 25.8)
  • Transvaginal ultrasound found a solid, unilocular mass of the right ovary measuring 34 by 20 by 16 mm
  • Both ovaries and the infracolic omentum were surgically removed
  • Tissue tests on the right ovary matched the chest biopsy, identifying the mass as spread of epithelioid malignant mesothelioma
  • Two months after surgery, CT showed no disease in the lower abdomen, but the primary chest tumor had progressed
  • The patient started second-line treatment with gemcitabine
  • The authors stated that, to their knowledge, ovarian spread from pleural mesothelioma had not been described before
• The authors' conclusion: The authors concluded that doctors should keep in mind the possibility of spread outside the chest from pleural mesothelioma. They recommended a whole-body CT scan with contrast, and possibly PET-CT, to look for distant spread before deciding treatment. They also noted that the role of PET-CT in diagnosing and staging this cancer is controversial.

Topics

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

Medical terms in this study, explained in our Lexicon: Metastasis, Pleural Mesothelioma, Pleura, Prognosis, Staging.

Related studies

• Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non-Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors — S. Hendry, R. Salgado, et al. (2017)
• PAX8 Expression in a Subset of Malignant Peritoneal Mesotheliomas and Benign Mesothelium has Diagnostic Implications in the Differential Diagnosis of Ovarian Serous Carcinoma — D.B. Chapel, A.N. Husain, et al. (2017)
• Cytokeratin 5/6 expression, prognosis, and association with estrogen receptor α in high-grade serous ovarian carcinoma — E.T. Taube, C. Denkert, et al. (2017)
• Monoclonal antibody SM047 as an immunohistochemical marker of ovarian adenocarcinoma — W.G. McCluggage, P. Maxwell, et al. (2001)
• Meningeal metastasis of a malignant peritoneal mesothelioma: A case report and literature review — Y. Jiang, Z. Mei, et al. (2019)
• Expression of calretinin in human ovary, testis, and ovarian sex cord-stromal tumors — Q.J. Cao, J.G. Jones, et al. (2001)

Browse more research in Tumori, or return to medical research.