Peritoneal mesothelioma

Our plain-English summary of Peritoneal mesothelioma, by J.R. Young, E.R. Reddy (Clinical Radiology, 1980).

The study

• Authors: J.R. Young, E.R. Reddy
• Journal: Clinical Radiology
• Published: 1980;31(3):243-7
• Type of article: Case report
• Cited by: 11 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. 002557).

Abstract

The clinical and radiological features of peritoneal mesothelioma in four patients with an industrial history of asbestos exposure are described. The radiological features of intestinal obstruction, soft tissue masses and displacement and infiltration of bowel are stressed. A normal chest radiograph does not exclude the diagnosis. More sensitive diagnostic imaging and perhaps the use of laparoscopy may help to improve the accuracy of pre-mortem diagnosis.

In plain English

This 1980 article from Queen Elizabeth Hospital, Gateshead, described the symptoms and X-ray findings of peritoneal mesothelioma (cancer of the lining of the abdomen) in four case reports. The patients were three men and one woman, aged 44 to 70. They died in the Gateshead area between 1973 and 1978. All had an industrial history of asbestos exposure: three men handled asbestos, and the woman worked in an asbestos factory's stores. Ten patients with peritoneal mesothelioma had post-mortem examinations at the hospital between 1965 and 1978. These four were the only ones who had abdominal X-ray examinations while alive. The time from first exposure to abdominal symptoms ranged from 20 to 45 years. Survival after symptoms began ranged from three months to three years. Two patients presented with subacute intestinal obstruction. In two, barium X-rays could not rule out colon cancer. One man's chest X-ray was normal when he first presented. The authors found the X-ray signs non-specific. They concluded that certain abdominal X-ray signs in asbestos-exposed workers should raise strong suspicion of the disease, and that a normal chest X-ray does not exclude it.

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 (four case reports) with review of radiological findings
• Who was studied: Four patients (three men aged 44, 60 and 55, one woman aged 70) with peritoneal mesothelioma who died in the Gateshead area between 1973 and 1978. They were the four, out of 10 patients with peritoneal mesothelioma examined post-mortem at Queen Elizabeth Hospital between 1965 and 1978, who had radiological examination of the abdomen during life.
• Exposure: Occupational asbestos exposure; fiber type not stated. Case 1 handled asbestos as a shipyard wireman for 25 years. Case 2 worked in an asbestos factory from age 14, first as a lagger, then in the stores, handling asbestos. Case 3 worked in the stores of an asbestos factory for 40 years; the article does not say she handled asbestos. Case 4 handled asbestos in an asbestos factory for 20 years and had left 17 years earlier.
• Main results:
  • Across the four patients, the latent period between initial exposure and abdominal symptoms ranged from 20 to 45 years.
  • Across the four patients, survival from onset of symptoms to death ranged from three months to three years.
  • Two patients (Cases 2 and 3) presented with subacute intestinal obstruction.
  • In two patients (Cases 1 and 4), the X-ray appearances alone could not rule out primary carcinoma of the colon.
  • Case 1's chest radiograph showed no abnormality when he first presented.
  • The radiological abnormalities in this series were non-specific. They did not distinguish peritoneal mesothelioma from other serosal malignancy.
  • At autopsy, Case 4 also had mesothelioma of the pleura over the left lower lobe. Among all 10 hospital post-mortem cases, five had pleural as well as peritoneal mesothelioma.
• The authors' conclusion: The authors concluded that, especially in patients with an industrial history of asbestos exposure, three findings should raise a high index of suspicion for peritoneal mesothelioma: radiological evidence of bowel obstruction, soft tissue masses displacing abdominal structures, and diffuse extrinsic indentation of the bowel on barium studies. They also concluded that a normal chest radiograph does not exclude the diagnosis, and hoped that computed tomography and laparoscopy may allow earlier diagnosis.

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, Asbestos Exposure, Chest X-Ray.

Related studies

• Peritoneal mesothelioma — M.P. Banner, V.K. Gohel (1978)
• Simultaneous bilateral spontaneous pneumothorax in a patient with peritoneal and pleural papillary mesothelioma — P. Höllinger, D. Gaeng (1997)
• Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature — S.C. Frontario, A. Loveitt, et al. (2015)
• Primary malignant peritoneal mesothelioma: appearance on F-18 FDG positron emission tomographic images — T.N. Eade, M.J. Fulham, et al. (2002)
• Lymphangitis carcinomatosa complicating primary malignant peritoneal mesothelioma — P.S. Craft, M.S. Reading, et al. (1996)
• Splenic localization of the peritoneal mesothelioma: case report and literature revue — D. D'Abbicco, A. Conversano, et al. (2012)

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