Peritoneal mesothelioma metastasis to the tongue - Comparison with 8 pleural mesothelioma reports with tongue metastases

Our plain-English summary of Peritoneal mesothelioma metastasis to the tongue - Comparison with 8 pleural mesothelioma reports with tongue metastases, by M.V. Vazquez, S. Selvendran, R. Cheluvappa, et al (Annals of Medicine and Surgery, 2016).

The study

• Authors: M.V. Vazquez, S. Selvendran, R. Cheluvappa, M.J. McKay
• Journal: Annals of Medicine and Surgery
• Published: 2016;5:101-5
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Purpose: Malignant mesothelioma (MM) rarely arises from the peritoneum. We describe the 1st such case which metastasised to the head and neck region (tongue).

Methods: We briefly surveyed the American Surveillance Epidemiology and End Results (SEER) database, and the British Cancer Research UK database for the latest trends in MM incidence. We did a systematic Pubmed search for other MM reports with tongue metastases.

Results And Presentation Of Case: American and British data show that MM incidence in men has stabilised in the last 10 years, earlier than previously predicted. The tongue is an unusual site for MM spread, with ours being only the 9th such case described. Our summary of published cases of MM metastasising to the tongue brings out our patient to be the least in age(35 years), and the only one to have peritoneal MM as the primary. Seven of the 9 cases were male. Only 2 had a recorded history of exposure to asbestos. All 9 patients had the epithelioid subtype of MM. Surgery was done as the exclusive reported intervention in 4 out of the 9 patients. Only 2 cases received radiotherapy, amongst whom, only our patient responded.

Conclusions: Metastasis of MM to the tongue is rare and usually in the uncommon context of MM with multiple sites of extra-thoracic or extra-abdominal spread. We have described a unique clinical manifestation of a rare subtype of mesothelioma. Moreover, we have tabulated and summarised details (including responses to surgery or/and radiotherapy) regarding all reported cases of mesotheliomas with tongue metastasis.

In plain English

This was a case report of one patient, plus a search of published reports and a brief look at cancer statistics. A 35-year-old man was diagnosed with peritoneal mesothelioma of a well differentiated papillary type. As the disease spread to the groin, pleura and chest wall, he had repeated surgery, heated chemotherapy inside the abdomen (HIPEC), intravenous chemotherapy and radiotherapy. At age 38 a mesothelioma tumour was found in his tongue. It was inoperable and was treated with radiotherapy, after which it was noted to have responded. He died 5 years after his first diagnosis. The authors' table recorded his asbestos exposure as absent; the case description did not discuss it. The authors found 8 earlier published cases of tongue spread, all pleural. Their patient was the youngest and the only peritoneal case. Seven of the 9 were male. The text says 2 had a history of asbestos exposure; the table caption says 3. Their look at US data showed mesothelioma incidence in men stabilised after 2006. The authors concluded this was the only recorded case of peritoneal mesothelioma spreading to the tongue.

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 one patient, with a literature search for other reported cases of mesothelioma spreading to the tongue and a brief survey of US (SEER) and UK cancer incidence data
• Who was studied: One 35-year-old man with peritoneal malignant mesothelioma, compared with 8 previously published cases of pleural mesothelioma with tongue metastases
• Exposure: The authors' table of the 9 cases marks asbestos exposure for this patient with a dash, which the table legend defines as absent. The case description does not discuss asbestos, and no fiber type or dose is given.
• Main results:
  • The patient's tongue lesion was confirmed as mesothelioma by biopsy when he was 38 years old, about 3 years after first presentation.
  • The tongue lesion was inoperable and was treated with radiotherapy to 50 Gy in 20 fractions.
  • The tongue mass was later noted to have responded to radiotherapy. The table describes this as a possible reduction in size.
  • The patient died 5 years after initial diagnosis.
  • Among the 9 known cases of mesothelioma spreading to the tongue, this patient was the youngest and the only one with peritoneal mesothelioma as the primary.
  • Seven of the 9 cases were male. The discussion text says 2 of the 9 had a history of asbestos exposure.
  • The table caption gives a different count: 3 of the 9 cases with a previous history of asbestos exposure.
  • The table caption says all 9 patients had the epithelioid subtype; the discussion says all 8.
  • In 4 of the 9 cases, surgical excision was the sole treatment or part of the treatment for the tongue metastasis.
  • Of the 2 cases given radiotherapy, only this patient responded. The other was described as having stable disease after 4 months.
  • In the authors' survey of US SEER data, mesothelioma incidence in men stabilised after 2006. In women it was relatively unchanged over the past 3 decades.
• The authors' conclusion: The authors concluded that this was the only recorded case of peritoneal mesothelioma spreading to the tongue. They considered it probably an unusual pattern of spread, from the abdomen to the chest and then to the mouth.
• Limitations the authors state:
  • The published reports of surgically treated tongue metastases did not describe local tumour control after surgery.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Metastasis, Pleural Mesothelioma, Malignant Mesothelioma, Peritoneum, Epidemiology, SEER, Epithelioid.

Related studies

• Tongue metastasis from a malignant diffuse mesothelioma of the pleura: report of a case — A. Piattelli, M. Fioroni, et al. (1999)
• Floor of mouth and tongue metastasis from malignant pleural mesothelioma — D. Kirke, K. Horwood, et al. (2010)
• Tongue metastasis was the first sign of malignant pleural mesothelioma detected by PET/CT — P. Xie, W. Wang, et al. (2020)
• Unusually Aggressive Presentation of Malignant Peritoneal Mesothelioma: Two Case Reports — D. Neff, B.C. Padberg Sgier, et al. (2022)
• Role of hyperthermic intraoperative peritoneal chemotherapy in the management of peritoneal metastases — D. Elias, D. Goéré, et al. (2014)
• Complete cytoreductive surgery plus HIPEC for peritoneal metastases from unusual cancer sites of origin: results from a worldwide analysis issue of the Peritoneal Surface Oncology Group International (PSOGI) — D. Goéré, G. Passot, et al. (2017)

Browse return to medical research.