Peritoneal mesothelioma associated with bladder cancer and occupational exposure to asbestos: A case report

Our plain-English summary of Peritoneal mesothelioma associated with bladder cancer and occupational exposure to asbestos: A case report, by D. Brahim, N. Mechergui, H. Ben Said, et al (Clinical Case Reports, 2020).

The study

• Authors: D. Brahim, N. Mechergui, H. Ben Said, D. Cherif, N. Ladhari, I. Youssef
• Journal: Clinical Case Reports
• Published: 2020;8(12):3529-3532
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelioma is a rare tumor usually located on the pleura. In this typical location, it is closely linked to asbestos exposure. However, in other locations such as in peritoneal mesothelioma, the association to asbestos remains unusual.

© 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

In plain English

This was a case report from Tunisia about one man with malignant peritoneal mesothelioma (a cancer of the lining of the abdomen) and bladder cancer. He was 48 years old and had smoked for 45 pack-years. For 19 years he had worked in a traditional brickyard. He worked around an old oven insulated with friable asbestos and cleaned it with a brush that held asbestos dust, without respiratory protection. The type of asbestos fiber in his workplace was not reported. Biopsies showed epithelioid malignant peritoneal mesothelioma together with urothelial bladder cancer. Chest imaging showed no signs of asbestos exposure. He received heated chemotherapy inside the abdomen, systemic chemotherapy and endoscopic bladder treatment. He was then lost to follow-up and returned to work. About 3 years later, PET imaging suggested a recurrence of the mesothelioma, and after repeat treatment he improved slightly. A Tunisian authority recognized the mesothelioma as occupational. The authors considered asbestos the cause of his mesothelioma and judged smoking the most likely cause of his bladder cancer. They concluded that asbestos's role in peritoneal mesothelioma is very likely.

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 (one patient)
• Who was studied: one man, aged 48 in the case description, with 45 pack-years of active smoking, seen at hospitals in Tunis, Tunisia
• Exposure: 19 years as a versatile worker in a traditional brickyard. He worked around an old oven containing friable asbestos used as thermal insulation and cleaned it at the end of shifts with a brush containing asbestos dust, with no respiratory protection. The fiber type in his workplace was not stated.
• Main results:
  • CT of chest, abdomen and pelvis showed diffuse infiltration of the peritoneal fat with ascites and focal involvement of the bladder wall
  • Biopsies of the peritoneal and bladder lesions showed malignant peritoneal mesothelioma of epithelioid subtype together with urothelial bladder cancer
  • Chest imaging showed no signs of asbestos exposure
  • He was treated with hyperthermic intraperitoneal chemotherapy (5-fluoro-uracil and cisplatin), six sessions of systemic etoposide at 100 mg per session, and endoscopic treatment of the bladder tumor. He was then lost to follow-up without repeat scans and resumed his usual work.
  • About 3 years later, PET imaging showed findings suggesting a recurrence of the peritoneal mesothelioma, with no signs of recurrence of the bladder tumor. No repeat biopsy was reported.
  • Repeat hyperthermic intraperitoneal chemotherapy brought slight improvement and stabilization on imaging
  • A Tunisian authority recognized the occupational origin of the mesothelioma
  • The authors judged active smoking to be the most likely cause of the bladder cancer. They said the different tissue types of the two tumors ruled out spread of the mesothelioma to the bladder.
• The authors' conclusion: The authors considered asbestos exposure the cause of this patient's peritoneal mesothelioma, in the absence of other factors. They concluded that the role of asbestos exposure in causing peritoneal mesothelioma is very likely.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Occupational Exposure, Mesothelioma, Pleura, Asbestos Exposure.

Related studies

• Use of job-exposure matrix in an occupational analysis of lung and bladder cancers on the basis of death certificates — D. Coggon, B. Pannett, et al. (1984)
• Occupational cancer of the urinary bladder in dyestuffs operatives and of the lung in asbestos textile workers and iron-ore miners — G.M. Bonser, J.S. Faulds, et al. (1955)
• Occupational asbestos exposure and urinary bladder cancer: a systematic review and meta-analysis — N. Franco, A. Godono, et al. (2023)
• Environmental and occupational exposures and prognosis in patients with non-muscle-invasive bladder cancer in the Be-Well Study — Z. Wang, M.L. Kwan, et al. (2024)
• Occupational exposure to asbestos and urinary bladder cancer — R. Molinini, L. Paoletti, et al. (1992)
• Arsenic, tobacco smoke, and occupation: associations of multiple agents with lung and bladder cancer — C. Ferreccio, Y. Yuan, et al. (2013)

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