Pleural malignant mesothelioma following Wilms' tumor

Our plain-English summary of Pleural malignant mesothelioma following Wilms' tumor, by M.B. Austin, R.E. Fechner, V.L. Roggli (American Journal of Clinical Pathology, 1986).

The study

• Authors: M.B. Austin, R.E. Fechner, V.L. Roggli
• Journal: American Journal of Clinical Pathology
• Published: 1986;86(2):227-30
• Type of article: Case report
• Cited by: 45 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. 000372).

Abstract

A 28-year-old woman had a left pleural malignant mesothelioma develop, which resulted in her death. At age four, she had undergone a left nephrectomy for Wilms' tumor and had received radiation therapy to the left renal fossa and to the right lung, the latter for a presumed diagnosis of metastatic tumor. Asbestos body counts of digested lung tissue were within the normal range. This is the fourth reported case of malignant mesothelioma following Wilms' tumor and is the first to provide quantitative analysis of asbestos in the lung.

In plain English

This article is a case report about one patient. At age four, she had her left kidney removed for Wilms' tumor, a childhood kidney cancer. She then received radiation to the left kidney area and, for presumed tumor spread, to the right lung. Exact radiation fields and doses were unknown. At age 28, she developed malignant mesothelioma of the left pleura and died two weeks after the surgery that diagnosed it. It appeared 24 years after radiation, on the kidney side and opposite the irradiated lung. Her lung tissue had asbestos body counts in the normal range. An electron microscope count found 3,900 fibers per gram of wet tissue, also normal; that count covered only fibers with a 5-micrometer length cut-off, and the scan garbles which way the cut-off runs. The authors described this as the fourth reported mesothelioma after Wilms' tumor and the first with a quantitative lung analysis showing no abnormal quantity of asbestos. They suggested that an inherited tendency linked to Wilms' tumor could conceivably also make a person susceptible to mesothelioma.

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, including autopsy and lung asbestos analysis)
• Who was studied: one woman treated for Wilms' tumor at age four who developed left pleural malignant mesothelioma at age 28
• Exposure: childhood radiation therapy to the right lung and the left renal fossa after left nephrectomy for Wilms' tumor. Asbestos was assessed only by measuring asbestos bodies and fibers in lung tissue, and the article does not name any fiber type.
• Main results:
  • Lung masses removed from the right lung 16 months after the nephrectomy showed no tumor.
  • At age 28 the patient had malignant mesothelioma of the left pleura. At autopsy the tumor encased the left lung.
  • The patient died two weeks after the thoracotomy.
  • The mesothelioma arose on the same side as the nephrectomy, 24 years after radiation therapy, and on the opposite side from the irradiated lung.
  • Both lung specimens counted by light microscopy had asbestos body counts in the normal range. The normal range was given as 0-20 asbestos bodies per gram of wet tissue.
  • Scanning electron microscopy found 3,900 fibers per gram of wet tissue, which the authors reported as within the normal range. The count was restricted to fibers with a 5-micrometer length cut-off, but the comparison symbol is garbled in the scan.
  • The authors reported the patient as the fourth reported case of malignant mesothelioma following Wilms' tumor.
  • The authors stated that this case provides the first quantitative lung tissue analysis indicating no abnormal quantity of asbestos in a mesothelioma following Wilms' tumor.
• The authors' conclusion: The authors suggested that there may be an inheritable tendency for Wilms' tumor that could conceivably also make a person susceptible to mesothelioma.
• Limitations the authors state:
  • The specific radiation fields and doses the patient received were not known.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Body Formation.

Related studies

• Glypican-3 expression in Wilms tumor and hepatoblastoma — J.A. Toretsky, N.L. Zitomersky, et al. (2001)
• Embryonic ultrastructure as a guide in the diagnosis of tumors — G.R. Dickersin (1987)
• Unusual cases: melanomatosis and nephroblastomatosis treated with hyperthermic intraperitoneal chemotherapy — A. Hayes-Jordan, H. Green, et al. (2012)
• Malignant peritoneal mesothelioma following radiotherapy for seminoma of the testis — R.J. Stock, Y.S. Fu, et al. (1979)
• Adenomatoid tumor of the pleura — H. Minato, T. Nojima, et al. (2009)
• Asbestos exposure and multiple primary tumors — V.A. Dohner, R.G. Beegle, et al. (1975)

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