Papillary peritoneal tumors in women

Our plain-English summary of Papillary peritoneal tumors in women, by A. Foyle, M. Al-Jabi, W.T. McCaughey (The American Journal of Surgical Pathology, 1981).

The study

• Authors: A. Foyle, M. Al-Jabi, W.T. McCaughey
• Journal: The American Journal of Surgical Pathology
• Published: 1981;5(3):241-9
• Cited by: 166 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. 004195).

Abstract

Twenty-five peritoneal tumors in women are described. All were partly or entirely of papillary or tubulopapillary structure and multifocal. Eight were unusually well-differentiated mesotheliomas. This appearance was associated with indolent behavior. In 10 cases the growth closely resembled serous papillary carcinoma, including the frequent presence of psammoma bodies, but the ovaries were free of primary tumor. The latter group of tumors progress rapidly and are thought to be derived from extraovarian mesothelium with müllerian potential. Four further cases showed some resemblance to ovarian papillary carcinoma. Only three tumors in the entire series (12%) closely resembled papillary or tubulopapillary diffuse malignant mesothelioma of the type that occurs in the pleural cavities in both sexes. The histopathologic spectrum of papillary tumors of peritoneum in women is extensive, and mesothelial tumors of the type known to be associated with asbestos are rare.

In plain English

This was a pathology case series from the Canadian Tumour Reference Centre in Ottawa. The authors searched their files and found 41 peritoneal tumors in women with a papillary or tubulopapillary structure. They excluded 16 for lack of data, leaving 25, which they sorted into five groups by microscopic appearance. The article does not report asbestos exposure for these patients. Two cases looked like marked mesothelial overgrowth suggesting mesothelioma. Six were well-differentiated papillary mesotheliomas that could be very slow-growing; one patient survived 29 years after the tumor was found. Only three of the 25 were the typical diffuse malignant mesothelioma seen in the pleura of both sexes, and the longest of these patients lived about 2½ years after symptoms began. Four were atypical diffuse mesotheliomas. Ten looked similar or identical to serous papillary carcinoma of the ovary, and most of these patients worsened rapidly. The authors suggested that epidemiological studies have overestimated how often diffuse malignant mesothelioma occurs in North American women. They proposed calling the ovarian-like tumors extraovarian papillary serous carcinomas.

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 series (review of pathology material from a tumor reference centre's files, with follow-up)
• Who was studied: 25 women with papillary peritoneal tumors from the files of the Canadian Tumour Reference Centre, Ottawa; 41 cases were found and 16 were excluded for lack of data on gross findings or the ovaries
• Exposure: The article does not report asbestos exposure for these patients. It classified tumors by microscopic appearance. The authors discussed asbestos only in relation to tumor type.
• Main results:
  • Two cases showed mesothelial hyperplasia suggesting mesothelioma; one of these patients was well 4 years later
  • Six women (aged 28 to 60) had well-differentiated papillary mesothelioma; one survived 29 years after the tumor was found, and the authors noted these tumors can be very indolent
  • Three women (aged 59, 53 and 52) had diffuse mesothelioma; the longest survivor lived about 2½ years after symptoms began, the shortest only a few months
  • Four women had atypical diffuse mesothelioma; psammoma bodies were found in three of the four
  • Ten women (aged 54 to 80) had tumors resembling serous papillary carcinoma of the ovary, without a primary ovarian tumor; most of these patients deteriorated rapidly
  • Only 3 of the 25 tumors were typical diffuse malignant mesothelioma
  • The authors reported that these 3 were the only definite diffuse malignant mesotheliomas among 64 peritoneal tumors in women on their files. They compared this with 26 of 60 (43.3%) peritoneal tumors in males in the same archive, figures taken from their earlier report.
  • The authors proposed classifying the 10 ovarian-like tumors as extraovarian papillary serous carcinomas
• The authors' conclusion: The authors suggested that epidemiological studies have overestimated the frequency of diffuse malignant mesothelioma in North American women. They thought this may be because other types of papillary mesothelial tumor were counted in that category.
• Limitations the authors state:
  • In one case the authors could not be certain whether the tumor started in the peritoneum, the pleura, or both

Topics

Medical terms in this study, explained in our Lexicon: Tubulopapillary, Well-Differentiated, Mesothelioma, Serous Papillary Carcinoma, Mesothelium, Carcinoma, Malignant Mesothelioma, Peritoneum.

Related studies

• Papillary tumors of the peritoneum in women: mesothelioma or papillary carcinoma — M. Kannerstein, J. Churg, et al. (1977)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Simultaneous bilateral spontaneous pneumothorax in a patient with peritoneal and pleural papillary mesothelioma — P. Höllinger, D. Gaeng (1997)
• Benign papillary mesothelioma of the peritoneum: a consideration in the differential diagnosis of peritoneal implants — G. Tzanakakis, K.S. McCully, et al. (1989)
• Well-differentiated papillary mesothelioma: peritoneal implants are not always metastases in the presence of cancer — G.W. Irwin, A. Ervine, et al. (2014)
• Peritoneal well-differentiated papillary mesothelioma coexisting with endometrial adenocarcinoma mimicking peritoneal carcinomatosis: A case report — Y.Y. Chen, P.C. Li, et al. (2020)

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