Peritoneal Deciduoid Malignant Mesothelioma on 67Ga SPECT/CT

Our plain-English summary of Peritoneal Deciduoid Malignant Mesothelioma on 67Ga SPECT/CT, by Y.C. Lai, Y.C. Wu, C.H. Kao, et al (Clinical Nuclear Medicine, 2019).

The study

• Authors: Y.C. Lai, Y.C. Wu, C.H. Kao, T.C. Hsieh, S.S. Sun
• Journal: Clinical Nuclear Medicine
• Published: 2019;44(2):161-163
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesotheliomas may be classified into epithelioid (60%), sarcomatoid (20%), or mixed (20%) type microscopically. Malignant deciduoid mesothelioma, a rare phenotype of epithelioid mesothelioma, arises more commonly from the peritoneum of young women, but is also from the pleura of elderly people. In the current report, the authors describe an unusual case of peritoneal malignant epithelioid mesothelioma with rare deciduoid phenotype demonstrated with Ga SPECT/CT.

In plain English

This was a short image-based case report about one patient, written by authors in Taiwan. A 64-year-old woman had intermittent fever and chills for 3 weeks despite antibiotic treatment. Her C-reactive protein, an inflammation marker, was above 38 mg/dL (normal below 0.8 mg/dL). Ultrasound suggested an abscess or tumor in the left liver region. A whole-body scan with the radioactive tracer gallium-67 showed increased uptake in the upper abdomen, plus unexpected spots in the chest and left lower neck. Combined SPECT/CT imaging located masses in the left supraclavicular fossa, the anterior mediastinum and the anterior upper abdomen. The authors judged these more likely to be malignant tumors than spread infection. A CT-guided biopsy of the abdominal tumor, with positive stains for cytokeratin and calretinin, confirmed deciduoid malignant mesothelioma, which the authors describe as a rare form of epithelioid mesothelioma. The authors noted that only one earlier case report had shown deciduoid peritoneal mesothelioma on a planar gallium-67 scan. The article did not mention asbestos exposure.

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, published as an 'Interesting Image')
• Who was studied: One 64-year-old woman, reported by authors at hospitals in Taiwan
• Exposure: Not reported; the article does not mention asbestos or any other exposure history
• Main results:
  • Blood testing in the patient showed C-reactive protein above 38 mg/dL (reference normal value below 0.8 mg/dL)
  • Abdominal ultrasound showed a suspected abscess or tumor in the left hepatic region
  • The planar whole-body gallium-67 scan showed increased radioactivity in the upper abdomen, plus unsuspected findings in the chest and left lower neck
  • SPECT/CT showed masses with increased radioactivity in the left supraclavicular fossa, the anterior mediastinum and the anterior upper abdomen, which the authors judged more likely to be malignant tumors than disseminated infection
  • The largest tumor, in the anterior upper abdomen, is printed as 'about 60 mL at its maximum transaxial diameter'
  • A CT-guided biopsy of the upper abdominal tumor, with positive immunohistochemical stains for cytokeratin and calretinin, confirmed deciduoid malignant mesothelioma
• The authors' conclusion: The authors presented this as an unusual case of peritoneal epithelioid mesothelioma with a rare deciduoid phenotype shown on gallium-67 SPECT/CT. They noted that only one earlier case report had shown diffuse deciduoid peritoneal mesothelioma on a planar gallium-67 scan.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Epithelioid, Sarcomatoid, Mesothelioma, Peritoneum, Pleura.

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• Gallium scanning in peritoneal mesothelioma — R.R. Armas, S.J. Goldsmith (1985)
• Biodistribution and Tumor Uptake of 67Ga-Nimotuzumab in a Malignant Pleural Mesothelioma Xenograft — V. Izquierdo-Sánchez, S. Muñiz-Hernández, et al. (2018)
• Deciduoid peritoneal mesothelioma. A report of the cytological appearances — F.R. Gillespie, J.D. van der Walt, et al. (2001)
• Primary malignant deciduoid peritoneal mesothelioma: a report of the cytohistological and immunohistochemical appearances — H. Ustun, H.M. Astarci, et al. (2011)
• Deciduoid peritoneal mesothelioma: CT findings with pathologic correlation — D.J. Chung, Y.W. Kang, et al. (2003)

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