Primary intrahepatic malignant epithelioid mesothelioma

Our plain-English summary of Primary intrahepatic malignant epithelioid mesothelioma, by I. Perysinakis, A.M. Nixon, I. Spyridakis, et al (International Journal of Surgery Case Reports, 2014).

The study

• Authors: I. Perysinakis, A.M. Nixon, I. Spyridakis, G. Kakiopoulos, C. Zorzos, I. Margaris
• Journal: International Journal of Surgery Case Reports
• Published: 2014;5(12):1098-101
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Primary malignant hepatic mesotheliomas are extremely rare. We report the case of a patient with primary intrahepatic malignant mesothelioma who was treated in our department.

Presentation Of Case: A 66-year old male patient was admitted to our department for the evaluation of anemia. An abdominal computed tomography scan revealed a large space occupying lesion in the right liver lobe.

Discussion: The tumor was subsequently resected and a diagnosis of primary intrahepatic malignant mesothelioma was made after pathologic examination. The patient did not receive adjuvant therapy and is currently alive and free of disease, 36 months after the resection.

Conclusion: To our knowledge this is the eighth adult case of primary intrahepatic malignant mesothelioma reported in the literature. These tumors are rarely diagnosed preoperatively. Absence of previous asbestos exposure does not exclude malignant mesothelioma from the differential diagnosis. Proper surgical treatment may offer prolonged survival to the patient, without adjuvant therapy.

Copyright © 2014. Published by Elsevier Ltd.

In plain English

This case report from a surgical department in Athens, Greece, described a 66-year-old man referred in November 2011 with two months of malaise and anemia that had not improved with iron tablets. The authors reported that he had no history of prior asbestos exposure or chronic liver disease. A CT scan showed a tumor 17 cm across in the right lobe of the liver, and the right part of the liver was surgically removed. Microscope and staining tests led to a diagnosis of primary intrahepatic malignant mesothelioma of the epithelioid type, meaning a cancer arising within the liver itself. The edges of the removed tissue were free of tumor. He received no chemotherapy afterward and was alive and free of disease 36 months after surgery. The authors counted this as the eighth adult case in the literature. Among the seven earlier cases they listed, five had no history of asbestos exposure, one had occupational asbestos exposure and asbestosis, and one did not say. The authors concluded that absence of previous asbestos exposure does not rule out malignant mesothelioma as a possible diagnosis. They also concluded that proper surgery may offer prolonged survival without additional therapy.

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), with a table of previously reported cases from the literature
• Who was studied: one 66-year-old man referred to the Third Surgical Department, "George Gennimatas" General Hospital of Athens, Greece, in November 2011
• Exposure: the authors reported that the patient had no history of prior asbestos exposure (and no chronic liver disease)
• Main results:
  • the patient had anemia that did not improve after two months of oral iron
  • CT showed a lesion in the right liver lobe measuring 17 cm in diameter
  • at surgery the mass in the right liver lobe showed no evidence of spread in the abdomen
  • a right hepatectomy (removal of the right part of the liver) was performed
  • the tumor was diagnosed as primary intrahepatic malignant mesothelioma of the epithelioid type
  • resection margins were free of disease
  • the patient did not receive chemotherapy after surgery
  • the patient was alive and free of disease 36 months after the operation
  • the authors stated this was, to their knowledge, the eighth adult case reported in the literature
  • among the seven earlier reported cases in the authors' table, five had no history of asbestos exposure, one had occupational asbestos exposure and pulmonary asbestosis, and one gave no indication
• The authors' conclusion: The authors concluded that this tumor is rarely diagnosed before surgery, that absence of previous asbestos exposure does not exclude malignant mesothelioma from the differential diagnosis, and that proper surgical treatment may offer prolonged survival without adjuvant therapy

Topics

Medical terms in this study, explained in our Lexicon: Epithelioid, Mesothelioma, Malignant Mesothelioma, Adjuvant Therapy, Asbestos Exposure, Differential Diagnosis.

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