Pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma

Our plain-English summary of Pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma, by R. Kassir, F. Forest, D. Kaczmarek (International Journal of Surgery Case Reports, 2013).

The study

• Authors: R. Kassir, F. Forest, D. Kaczmarek
• Journal: International Journal of Surgery Case Reports
• Published: 2013;4(11):942-4
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Primary Pulmonary Mucinous Cystadenocarcinoma PPMC is an extremely rare subtype of pulmonary adenocarcinoma, with only a few dozen cases reported in the literature to date.

Presentation Of Case: We report a extremely rare case of pulmonary mucinous cystadenocarcinoma presenting as a pleural mesothelioma. 53-year-old man exposed to asbestos, he is admitted in hospital with a 5cm mass in right pleura. He was treated by wedge resection. Sparse groups of malignant cells were microscopically observed in pools of mucin. The postoperative histopathological findings were in accordance with the diagnosis of pulmonary mucinous cystadenocarcinoma on cystic adenoid malformation of lung. 5 years later, the patient has no recurrence.

Discussion: PPMC is usually asymptomatic; hemoptysis is seen occasionally. Preoperative diagnosis is very difficult to establish. Both FNA cytology and transbronchial lung biopsy seem inadequate. Our patient went on to undergo open lung biopsy and histopathological testing that confirmed the diagnosis of PMC.

Conclusion: It is important to differentiate this rare pathological feature of the lung from other lung tumors as the treatment is surgical rather than medical. Thoracic surgeons should bear in mind this rare tumor for the differential diagnosis of a pleural mesothelioma because this tumor has a favorable prognosis.

Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

In plain English

This article is a case report about one patient. The authors described a 49-year-old former smoker exposed to asbestos (the article's abstract says 53) who was admitted with a mass in the right lung. A CT scan showed a 5 cm by 7 cm mass in the right lower lobe that seemed to be pleural. Because of chest pain, the asbestos exposure and the scan, the doctors suspected pleural mesothelioma or sarcoma. The article did not describe the asbestos type or how exposure occurred. A wedge resection was done without a needle biopsy or bronchoscopy beforehand. Tissue examination showed primary pulmonary mucinous cystadenocarcinoma, a rare type of lung cancer, on a type 2 cystic adenoid malformation of the lung. A lobectomy followed, and five years later the patient had no recurrence. The authors concluded that thoracic surgeons should consider this tumor when pleural mesothelioma is suspected. They wrote that they should have sought a diagnosis before surgery, which could have avoided a second operation.

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)
• Who was studied: One 49-year-old former smoker exposed to asbestos, admitted to a general and thoracic surgery unit in Saint Etienne, France, for a mass in the right lung. The article's abstract gives the age as 53.
• Exposure: Asbestos exposure, with no fiber type, job, product or dose described. The patient was also a former smoker.
• Main results:
  • A CT scan showed a heterogeneous mass of 5 cm by 7 cm in the lower lobe of the right lung. It seemed to be pleural, and pleural mesothelioma or sarcoma was suspected.
  • The multidisciplinary team decided on a wedge resection without first doing a needle aspiration, bronchoscopy or FNA.
  • Tissue examination after surgery found primary pulmonary mucinous cystadenocarcinoma on a type 2 cystic adenoid malformation of the lung.
  • A lobectomy was then performed, followed by surveillance. Five years later the patient had no recurrence.
• The authors' conclusion: The authors concluded that pleural mesothelioma should be added to the list of conditions this tumor can be mistaken for. They said thoracic surgeons should keep this rare tumor in mind when pleural mesothelioma is suspected, because its treatment is surgical and its prognosis favorable.
• Limitations the authors state:
  • The authors stated they should have made more effort to confirm the diagnosis before surgery. A diagnosis made before surgery could have prevented the second operation under general anesthesia that their patient needed.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Adenocarcinoma, Pleura, Hemoptysis, Cytology, Biopsy, Differential Diagnosis, Prognosis.

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