Primary omental mesothelioma: a rare but important differential diagnosis in previous asbestos exposure

Our plain-English summary of Primary omental mesothelioma: a rare but important differential diagnosis in previous asbestos exposure, by A. Harb, E. King, H. Lloyd, et al (Journal of Gastrointestinal Surgery, 2010).

The study

• Authors: A. Harb, E. King, H. Lloyd, Z. Harb, J.G. Payne
• Journal: Journal of Gastrointestinal Surgery
• Published: 2010;14(2):423-5
• Type of article: Case report
• Read it: PubMed · Publisher

Abstract

Primary omental mesothelioma is a malignant tumour of the mesothelial cells of the omentum, related to asbestos exposure. It is an extremely rare condition that presents both diagnostic and therapeutic challenges. We present a review of the related literature and report on a fatal case of primary omental mesothelioma in a 70 year old man, presenting with a painful abdominal mass. Radiological imaging was not diagnostic but useful in excluding other pathologies. Diagnosis relied on specific immunohistochemical analysis. The difficulty in diagnosis and management and the advanced stage of disease meant that prognosis was very poor. Our patient died within 3 weeks of diagnosis.

In plain English

This article was a case report with a short discussion of earlier published reports. It described one 70-year-old Hungarian man with previous occupational exposure to asbestos. The article did not name a fiber type or job. He had three months of abdominal pain, increasing lethargy, loss of appetite and a 20 kg weight loss, with a very painful mass in the upper right abdomen. His Ca125 tumor marker was 360, while other tumor markers were normal. A CT scan showed diffuse infiltration of the omentum, a fatty layer inside the abdomen. The appearance was nonspecific, and a barium enema and colonoscopy were normal. The authors reported that imaging did not make the diagnosis but helped exclude other conditions. Needle biopsies of the omentum were examined with immunohistochemical stains, and malignant mesothelioma was diagnosed. He died in hospital 3 weeks after diagnosis. The authors concluded that asbestos exposure is likely to have a causative relation, as in the more common pleural and peritoneal mesotheliomas.

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 a single patient, with a brief review of related literature in the discussion
• Who was studied: One 70-year-old Hungarian man, treated at Queen Mary's Hospital, Sidcup, Kent, UK. Dates of care were not given.
• Exposure: Previous occupational exposure to asbestos. Fiber type, job and amount of exposure were not described.
• Main results:
  • The patient presented with a 3-month history of abdominal pain, increasing lethargy, loss of appetite, and weight loss of 20 kg.
  • The patient's Ca125 tumor marker was 360. CEA, Ca19.9, B-HCG and AFP were within normal limits.
  • A CT scan showed diffuse infiltration of the omentum. The appearances were nonspecific.
  • Radiological imaging was not diagnostic but was useful in excluding other pathologies.
  • Ultrasound-guided percutaneous biopsies of the omentum were examined with immunohistochemical staining, and a diagnosis of malignant mesothelioma was made.
  • The patient died 3 weeks after diagnosis.
• The authors' conclusion: The authors concluded that asbestos exposure is likely to have a causative relation with primary omental mesothelioma, as in the more common pleural and peritoneal mesotheliomas. They noted the condition had been reported only twice before, so little epidemiological data are known.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Differential Diagnosis, Asbestos Exposure, Mesothelial Cells, Omentum, Prognosis.

Related studies

• Extragastrointestinal Stromal Tumor Presenting as Omental Cyst — A. Monabati, M. Safavi, et al. (2016)
• CT-guided core-needle biopsy in omental pathology — F. Pombo, E. Rodriguez, et al. (1997)
• Surgical biopsy studies of omental and peritoneal nodules — D.B. Walsh, G. Williams (1971)
• Loss of BAP1 expression is very rare in peritoneal and gynecologic serous adenocarcinomas and can be useful in the differential diagnosis with abdominal mesothelioma — J. Andrici, J. Jung, et al. (2016)
• Primary malignant mesothelioma of the greater omentum: report of a case — Y.C. Liu, Y.L. Kuo, et al. (2004)
• Angiography of omental mesothelioma — K. Marini, J.F. Walter (1984)

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