Primary myxoid sarcoma of the pleura: 5 years follow-up

Our plain-English summary of Primary myxoid sarcoma of the pleura: 5 years follow-up, by R. Tosson, M. Krismann (The Thoracic and Cardiovascular Surgeon, 2000).

The study

• Authors: R. Tosson, M. Krismann
• Journal: The Thoracic and Cardiovascular Surgeon
• Published: 2000;48(4):238-40
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Primary sarcomas of the pleura are rare intrathoracic tumours. We describe a case of a recurring myxoid pleural sarcoma in a 51-year-old male patient with coronary heart disease, who initially was admitted for coronary revascularization surgery. Tumour diagnosis was based on pathological examination of a biopsy after radiological detection of a nodule in the right upper lobe. The nodule was excised. The first recurrence was diagnosed after 15 months. Pleuropneumonectomy was done. Four years after the first excision further tumour masses appeared above the diaphragm and were surgically removed and adjuvant irradiation carried out. A year later the patient is doing well.

In plain English

This case report described one 51-year-old man with a history of asbestos exposure from 1956 to 1962. He developed a tumour that the authors classified as a myxoid sarcoma, not otherwise specified, of the pleura. A nodule in the right upper lobe was seen on chest X-rays before coronary bypass surgery in 1994 and was removed during that operation. In August 1995, fifteen months later, the tumour returned in the right chest, and the patient underwent pleuropneumonectomy in September. Lung dust analysis found a slightly elevated asbestos content, up to 60 asbestos bodies per gram of lung tissue. The article did not name a fiber type. In May 1998 a further mass was found above the diaphragm; it came to press on the superior vena cava and was later removed. The removed tumour showed progression to a round cell variant, and the patient received 50 Gy of radiation. The authors stated they could not prove the tumour was asbestos-related. They reported the patient doing well after five years of follow-up and encouraged extensive surgery in proven pleural sarcoma.

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)
• Who was studied: One 51-year-old man with coronary heart disease and a history of asbestos exposure, followed for five years. The authors work at the Bergmannsheil hospital, Ruhr University, Bochum, Germany.
• Exposure: Past asbestos exposure from 1956 to 1962. No fiber type, product or job is named. Lung dust analysis found a slightly elevated asbestos content, up to 60 asbestos bodies per g of lung tissue.
• Main results:
  • The tumour first recurred 15 months after the initial excision, in August 1995, with breathlessness and pleural effusion.
  • Pleuropneumonectomy was performed in September 1995.
  • The pleuropneumonectomy specimen showed tumour of the parietal and visceral pleura. There was no invasion of lung tissue, but the tumour had infiltrated the pericardium and diaphragm.
  • Of the immunohistochemical antibodies tested, only vimentin reacted with the tumour cells.
  • The tumour was classified as myxoid sarcoma not otherwise specified, because features to determine its tissue of origin were not available.
  • In May 1998 a further mass above the diaphragm was detected on CT and an operation was planned.
  • The patient was admitted before the scheduled operation with signs of upper mediastinal obstruction; the mass was compressing the superior vena cava.
  • The removed mediastinal tumour showed progression to a round cell variant.
  • After this operation the patient received adjuvant irradiation of the right hemithorax and mediastinum, total dose 50 Gy.
  • The patient had been followed for five years and was doing well when the paper was written.
• The authors' conclusion: The authors stated they could not prove the tumour was asbestos-related. They noted that if asbestos caused primary myxoid pleural sarcoma, it would probably be seen more frequently. They encouraged thoracic surgeons to undertake extensive surgery in proven pleural sarcoma, even when it recurs.
• Limitations the authors state:
  • The authors stated that features needed to determine the tumour's tissue of origin were not available, so it could only be classified as not otherwise specified.

Topics

Medical terms in this study, explained in our Lexicon: Sarcoma, Pleura, Intrathoracic, Biopsy, Diaphragm.

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