Perineal and colonic metastases in two cases of malignant mesothelioma

Our plain-English summary of Perineal and colonic metastases in two cases of malignant mesothelioma, by B. Grewal, G. Reid, H. Lord (Lung Cancer, 2012).

The study

• Authors: B. Grewal, G. Reid, H. Lord
• Journal: Lung Cancer
• Published: 2012;77(1):235-8
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Two patients with rare sites of metastatic pleural mesothelioma are presented and the literature on similar cases is examined. One patient developed colonic metastases from a sarcomatoid mesothelioma. Another patient with epithelioid mesothelioma developed perineal metastases.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

In plain English

This article is a case report of two men with malignant pleural mesothelioma that spread to unusual sites. The authors also discussed earlier published cases. The first man, a 69-year-old retired engineer, had sarcomatoid mesothelioma of the left pleura. Nine months after diagnosis he was admitted to hospice care with anaemia. A colonoscopy found a polyp in the sigmoid colon that was a malignancy in keeping with mesothelioma. He was given a blood transfusion rather than surgery and died of progressive disease some weeks later. The second man, a 62-year-old retired engineer, had epithelioid mesothelioma of the left pleura. Two years after diagnosis he had skin metastases in the perineum, which CT suggested had arisen from a patent processus vaginalis. Radiotherapy improved his symptoms, and he died of aspiration pneumonia six weeks later. The authors stated that, to their knowledge, pleural epithelioid mesothelioma spreading to the tunica vaginalis testis had not been reported before. The article does not mention asbestos exposure. The authors concluded that such cases are a reminder to keep an open mind when mesothelioma patients present with apparently unrelated symptoms.

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 of two patients, with a discussion of previously published similar cases
• Who was studied: Two men with pleural mesothelioma, a 69-year-old and a 62-year-old, both retired engineers. The authors were from the Department of Oncology, Ninewells Hospital, Dundee, Scotland. No dates of the cases are given.
• Exposure: Not reported. The article does not mention asbestos or any other exposure; both patients are described only as retired engineers.
• Main results:
  • Case 1: Butchart Stage I sarcomatoid mesothelioma limited to the left side of the chest cavity, without evidence of systemic metastases. Four cycles of carboplatin and pemetrexed resulted in stable disease.
  • Case 1: Nine months after diagnosis the patient was admitted to hospice care because of anaemia. A colonoscopy found a sigmoid colon polyp showing a poorly differentiated malignancy in keeping with mesothelioma.
  • Case 1: The anaemia was treated with blood transfusion rather than removal of the polyp, and the patient died of progressive disease some weeks later.
  • Case 2: Butchart Stage I epithelioid mesothelioma limited to the left pleural cavity. Four cycles of cisplatin and pemetrexed led to a partial response. Chest wall subcutaneous metastases were later removed, and second-line chemotherapy was given.
  • Case 2: Two years after diagnosis, fixed skin metastases were found in the perineum between the rectum and scrotum. A fine needle aspirate indicated these were likely metastatic mesothelioma, and imaging also showed ascites and omental caking.
  • Case 2: Radiotherapy of 20 Gray to the perineal region gave marked symptomatic improvement. The patient died of aspiration pneumonia six weeks later.
  • The authors stated that, to their knowledge, pleural epithelioid mesothelioma spreading to the tunica vaginalis testis had not been reported before.
• The authors' conclusion: The authors concluded that the two cases add to the limited literature on the spread of pleural mesothelioma. They wrote that rare metastatic sites may become more common as survival improves, and that the cases serve as a reminder to keep an open mind when mesothelioma patients present with apparently unrelated symptoms.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleural Mesothelioma, Sarcomatoid, Epithelioid.

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