Peritoneal mesothelioma. A report of 4 cases

Our plain-English summary of Peritoneal mesothelioma. A report of 4 cases, by G.H. Roberts, R.W. Irvine (The British Journal of Surgery, 1970).

The study

• Authors: G.H. Roberts, R.W. Irvine
• Journal: The British Journal of Surgery
• Published: 1970;57(9):645-50
• Cited by: 44 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. 001407).

Abstract

Four cases of peritoneal mesothelioma occurring in 1 hospital in the course of 1 year are reported. The clinical picture is relatively non-specific and dominated by progressive abdominal distension and pain; all 4 patients died within 13 months. The value of cytology, laparotomy, and peritoneal biopsy as aids to diagnosis is discussed. Evidence of exposure to asbestos was found in 3 of the 4 cases. No treatment appears to alter the fairly rapid progression of the disease, and palliation of symptoms is all that can be offered.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article reported four cases of peritoneal mesothelioma, a tumour of the lining of the abdomen. All four were seen within 12 months of each other at the Southern General Hospital, Glasgow. The patients were a man who had worked for 44 years as a pipe insulator in shipyards, handling wet asbestos almost daily; a 67-year-old housewife; a 68-year-old labourer with asbestos exposure over the previous 6 years; and a 59-year-old housewife. Their illness was dominated by abdominal swelling and pain, and all four died within 13 months. Evidence of asbestos exposure was found in three of the four. Autopsies on these three found asbestos bodies in the lungs: numerous in the two men, who also had minimal asbestosis and pleural plaques, and scanty in the first housewife, whose source of exposure could not be determined. No exposure history was obtained for the second housewife. Her sputum was not tested and she had no autopsy. Treatment with cyclophosphamide showed no worthwhile benefit. The authors concluded that no treatment appeared to alter the fairly rapid progression of the disease and that only relief of symptoms could be offered.

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 (report of 4 cases)
• Who was studied: 4 patients with peritoneal mesothelioma (2 men: an insulating engineer and a 68-year-old labourer; 2 women: housewives aged 67 and 59) seen within 12 months at the Southern General Hospital, Glasgow
• Exposure: Asbestos (fiber type not stated): Case 1 worked 44 years as a pipe insulator in shipyards handling wet asbestos almost daily; Case 3 had exposure for the previous 6 years; Case 2 had scanty lung asbestos bodies of undetermined source; no exposure found for Case 4
• Main results:
  • All 4 patients died within 13 months.
  • Evidence of asbestos exposure was found in 3 of the 4 cases.
  • Case 1 (the insulator): lung smears at autopsy showed approximately 3000 asbestos bodies per 600 low-power fields.
  • Case 2 (67-year-old housewife): lung smears showed scanty asbestos bodies (fewer than 10 per 600 low-power fields). The authors said it was not possible to say whether her exposure was occupational, domestic, or environmental.
  • Cases 1 and 3 (the two men) had histological evidence of minimal asbestosis and an occupational history of exposure, and hyaline pleural plaques were found in both.
  • Case 4 (59-year-old housewife): no evidence of asbestos exposure was obtained on questioning.
  • Cyclophosphamide given systemically and into the abdominal cavity showed no evidence of worthwhile benefit. In Case 4 it caused significant but temporary bone-marrow depression requiring blood transfusion.
  • On biopsy, Case 3 showed a mesenchymal pattern and the other 3 an epithelial structure. At autopsy, Case 3 showed a mixed epithelial and mesenchymal pattern.
• The authors' conclusion: The authors concluded that the clinical picture is relatively non-specific, that no treatment appears to alter the fairly rapid progression of the disease, and that palliation of symptoms is all that can be offered.
• Limitations the authors state:
  • All biopsy reports stressed that undetected primary tumours elsewhere could not be completely excluded. The authors noted that a biopsy-only diagnosis such as Case 4 would be classed as 'probable mesothelioma'.
  • In Case 4 sputum was not examined for asbestos bodies, and there was no autopsy.

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, Cytology, Laparotomy, Biopsy.

Related studies

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• The value of BRCA-1-associated protein 1 expression and cyclin-dependent kinase inhibitor 2A deletion to distinguish peritoneal malignant mesothelioma from peritoneal location of carcinoma in effusion cytology specimens — W. Althakfi, S. Gazzo, et al. (2020)
• Mesothelioma of the abdomen in women. Monitoring of therapy by peritoneal fluid study — L. McGowan, B. Bunnag, et al. (1975)
• Acute popliteal thrombus workup leads to discovery of primary peritoneal mesothelioma in the absence of any known asbestos exposure — S.T. Ahmed, M. Barvo, et al. (2020)
• Loose mesothelial cysts in the peritoneal cavity — Y. Ramirez, J. Rosai, et al. (2010)
• Metastatic peritoneal mesothelioma in the setting of recurrent ascites: a case report — V. Samedi, S. White, et al. (2010)

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