Radiology-pathology conference: primary peritoneal mesothelioma

Our plain-English summary of Radiology-pathology conference: primary peritoneal mesothelioma, by A.S. Baadh, X. Xiong, S. Singh, et al (Clinical Imaging, 2013).

The study

• Authors: A.S. Baadh, X. Xiong, S. Singh, R. Kapoor, J. Zhou, D.S. Katz
• Journal: Clinical Imaging
• Published: 2013;37(6):1142-5
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Primary peritoneal mesothelioma is a rare neoplasm which carries a dismal prognosis. These highly aggressive tumors arise from mesothelial cells lining the peritoneum and are rapidly fatal. The neoplasm is typically associated with crocidolite asbestos exposure. We present the case of a 75-year-old man with primary peritoneal mesothelioma, with invasion into the right hepatic lobe.

© 2013 Elsevier Inc. All rights reserved.

In plain English

This article was a case report of one patient with primary peritoneal mesothelioma, a cancer of the abdominal lining, at Winthrop-University Hospital in New York. The patient was a 75-year-old man, a retired Navy cook who worked on a ship for most of his life, with a 90-pack-year smoking history. The report did not describe any asbestos exposure for him. He had five weeks of nausea, weight loss, night sweats and abdominal discomfort, and a platelet count of 575,000. A CT scan showed a mass of about 10×8.5×8.5 cm in the abdominal cavity growing directly into the right lobe of the liver, with smaller lesions nearby in the liver. A fine-needle sample showed a staining pattern the authors called typical of sarcomatoid mesothelioma, confirming the diagnosis. Surgery was not advised because the disease was advanced. He received cisplatin and pemetrexed chemotherapy. About 4 months after first presenting, he returned with worsening pain. He was moved to hospice care and died there one day after that transfer. The authors concluded that this tumor is highly aggressive and rapidly fatal, and hoped to raise radiologists' awareness of it.

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), with a discussion of published literature
• Who was studied: One 75-year-old man treated at Winthrop-University Hospital, Mineola, New York, USA. He had a 5-week history of nausea, retching, unintended weight loss, night sweats and abdominal discomfort.
• Exposure: The article does not report an asbestos exposure history for this patient. It states his occupation as a retired Navy cook who worked on a ship for most of his life, and a 90-pack-year smoking history (he quit 25 years before presentation).
• Main results:
  • CT showed a combined peritoneal and liver mass of approximately 10×8.5×8.5 cm, extending directly into liver segment 7, with multiple smaller satellite lesions in the right hepatic lobe.
  • CT showed no enlarged lymph nodes in the retroperitoneum, pelvis or mesentery.
  • On fine-needle aspiration, tumor cells were strongly positive for calretinin, CAM 5.2 and vimentin and negative for CD34, S100 and AFP. The authors said this profile is typically seen in sarcomatoid mesothelioma, confirming the diagnosis.
  • Blood work showed thrombocytosis, with a platelet count of 575,000.
  • Because the disease was advanced, surgery was not advised. The patient received systemic chemotherapy with cisplatin and pemetrexed.
  • About 4 months after first presentation, the patient returned with worsening abdominal pain and dehydration. He was later transferred to hospice care and died there 1 day after the transfer. The article does not give the interval between his return to hospital and his death.
• The authors' conclusion: The authors concluded that primary malignant peritoneal mesothelioma is a highly aggressive tumor arising from mesothelial cells lining the peritoneum and is rapidly fatal. They said they hoped to heighten radiologists' awareness of these tumors.

Topics

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

Medical terms in this study, explained in our Lexicon: Pathology, Peritoneal Mesothelioma, Neoplasm, Prognosis, Mesothelial Cells, Peritoneum, Crocidolite, Asbestos Exposure.

Related studies

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• Concerning CT features predict outcome of treatment in patients with malignant peritoneal mesothelioma — P.H. Sugarbaker, D. Chang, et al. (2021)
• An unusual liver mass: primary malignant mesothelioma of the liver : CT and MRI findings and literature review — A. Serter, N. Buyukpinarbasili, et al. (2015)
• Benign cystic mesothelioma of the liver: A rare hepatic cyst — W. Wang, H.Y. Lai, et al. (2021)
• Primary peritoneal mesothelioma: case series and literature review — H. Sharma, I. Bell, et al. (2011)
• Difficult to Identify: Malignant Primary Peritoneal Mesothelioma — B.S. Zha, M. Flanagan, et al. (2015)

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