Primary Malignant Deciduoid Mesothelioma: A Challenging Diagnosis

Our plain-English summary of Primary Malignant Deciduoid Mesothelioma: A Challenging Diagnosis, by M. Regragui, N.B. Guebessi (Archives of Pathology & Laboratory Medicine, 2019).

The study

• Authors: M. Regragui, N.B. Guebessi
• Journal: Archives of Pathology & Laboratory Medicine
• Published: 2019;143(4):531-533
• Type of article: Review
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Primary malignant deciduoid mesothelioma is a rare subtype of epithelioid mesothelioma that was first described in the peritoneum in young women without a history of asbestos exposure. It was thought to be a distinct clinicopathologic entity with ominous prognosis; recent studies have better characterized this entity. On morphology, primary malignant deciduoid mesothelioma is characterized by cytomorphologic features resembling decidualized tissue. Pleomorphism is variable. The immunoprofile is similar to other epithelioid mesotheliomas. The prognosis is the same as other epithelioid mesotheliomas and seems to depend on histological grade.

In plain English

This was a short review of published reports on primary malignant deciduoid mesothelioma, a rare form of epithelioid mesothelioma whose cells resemble decidualized tissue. The authors work in pathology in Casablanca, Morocco. The review reported no new patients or data of its own. According to the review, the variant represents less than 5% of mesotheliomas. The first reported cases suggested that it affected young women without a history of asbestos exposure and occurred only in the peritoneum. More recent reviews found it in both sexes, with a slight male predominance, and found the pleural location more common than the peritoneum. It has been reported in people aged 8 to 75 and has also been associated with asbestos exposure. The review also described the tumor's microscopic appearance, its staining pattern, other tumors it can be confused with, and treatment. The tumor was once thought to be more aggressive, but it did not appear to have a worse outcome than conventional epithelioid mesothelioma, apart from a high-grade subgroup. The authors concluded that pathologists should be aware of it because high-grade cases can carry a poor outcome.

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: Narrative review (a 'Resident Short Review') of published literature. It contains no original patient data and does not describe a literature search method.
• Who was studied: Published reports and studies on primary malignant deciduoid mesothelioma. The number of studies reviewed and how they were selected are not stated. The authors are from the Pathology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
• Exposure: No exposure was studied. The review noted that early reports described patients without asbestos exposure, but that the variant has also been reported in association with asbestos exposure.
• Main results:
  • According to the review, primary malignant deciduoid mesothelioma represents less than 5% of mesotheliomas.
  • The first reported cases suggested that the variant affected young women without a history of asbestos exposure and was located only in the peritoneum.
  • More recent reviews showed that it occurs in both sexes, with a slight male predominance.
  • Pleural, pericardial and paratesticular cases have been described. The pleural location was more common than the peritoneum.
  • The variant has been reported in a wide age range (8 to 75 years) and has also been associated with asbestos exposure.
  • Its immunostaining profile is the same as that of other epithelioid mesotheliomas.
  • Although it was thought to behave more aggressively, the variant does not seem to have a worse outcome than conventional epithelioid mesotheliomas.
  • A subgroup with marked pleomorphism, decreased cell cohesion, atypical mitotic figures and a high mitotic rate seems to have a highly aggressive clinical course.
  • Treatment is the same as for other subtypes of diffuse mesothelioma, based on cytoreductive surgery combined with chemotherapy.
• The authors' conclusion: The authors concluded that pathologists should be aware of this rare malignancy because high-grade cases can carry a poor outcome, and because it can be easily confused with other neoplastic and nonneoplastic peritoneal lesions.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Epithelioid, Peritoneum, Asbestos Exposure, Prognosis.

Related studies

• Mesotheliomas with deciduoid morphology: a morphologic spectrum and a variant not confined to young females — J.H. Shanks, M. Harris, et al. (2000)
• Deciduoid or pseudodecidual mesothelioma — A. Talerman (2000)
• Peritoneal Deciduoid Mesothelioma: An Unusual Presentation Complicating an Already Challenging Diagnosis — N. Dominiak, W. Graybill, et al. (2017)
• Challenging and uncommon diagnosis of long-evolution ascites — M. Gravito-Soares, E. Gravito-Soares, et al. (2017)
• Primary malignant deciduoid peritoneal mesothelioma: a report of the cytohistological and immunohistochemical appearances — H. Ustun, H.M. Astarci, et al. (2011)
• Pregnancy-related peritoneal ectopic decidua (deciduosis): morphological and clinical evaluation — F. Bolat, T. Canpolat, et al. (2012)

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