Rib destruction: a neglected finding in malignant mesothelioma

Our plain-English summary of Rib destruction: a neglected finding in malignant mesothelioma, by R.M. Steiner, M.W. Cooper, H. Brodovsky (Clinical Radiology, 1982).

The study

• Authors: R.M. Steiner, M.W. Cooper, H. Brodovsky
• Journal: Clinical Radiology
• Published: 1982;33(1):61-5
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is extensively described in the radiological literature, but the incidence and importance of rib destruction has not been emphasised. In this communication, four patients with extensive mesothelioma and contiguous rib destruction are described. They represent 12% of the collected series of 36 patients. The differential diagnosis of a pleural mass with rib destruction is discussed.

In plain English

This article was a small case series from Thomas Jefferson University Hospital in Philadelphia. It looked at rib destruction seen on X-rays in patients with malignant mesothelioma. The authors searched hospital records from 1970 to 1979 and found 36 patients with a pathologically supported diagnosis of malignant mesothelioma. When they reviewed all 36 patients' radiographs, four showed rib erosion, which the authors reported as 12% of the series. Pathologists re-examined tissue from these four patients and confirmed the diagnosis in each. The four were three men, aged 47, 75 and 68, and one woman aged 66. In each case the damaged ribs were next to a tumour mass in the pleura, the lining around the lung. One man gave no history of asbestos exposure. Another had worked as a pipe fitter in the Philadelphia Navy Yard for six months, 30 years before admission. All four patients died. The authors stated that rib destruction in mesothelioma had not been emphasised in the radiological literature. They also discussed other conditions that can cause a pleural mass with rib destruction.

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 series: a review of hospital records and radiographs, with four case reports
• Who was studied: 36 patients with a pathologically supported diagnosis of malignant mesothelioma in the records of Thomas Jefferson University Hospital, Philadelphia, 1970 to 1979. Four of them are described in detail: men aged 47, 75 and 68, and a woman aged 66.
• Exposure: The study did not examine asbestos exposure, and no fiber types are named. Occupational history is given for one patient (Case 3): six months as a pipe fitter in the Philadelphia Navy Yard, 30 years before admission. Another patient (Case 2) gave no history of asbestos exposure.
• Main results:
  • Rib erosion was found on the radiographs of 4 of the 36 patients with malignant mesothelioma, reported as 12% of the series.
  • In the four patients with rib erosion, re-review of the pathological specimens confirmed malignant mesothelioma in each case.
  • Case 1 (man, 47): a large right pleural mass with erosion of the right third and fourth ribs.
  • Case 2 (man, 75; diffuse fibrous mesothelioma; no asbestos history given): destruction of the third rib and erosion of the left fourth rib.
  • Case 3 (man, 68): the left third, fourth and fifth ribs were destroyed on their inner sides, next to the mass.
  • Case 4 (woman, 66): bony erosion of the left ninth and tenth ribs. She died in August 1979, and no autopsy was permitted.
• The authors' conclusion: The authors stated that although malignant mesothelioma is extensively described in the radiological literature, the incidence and importance of rib destruction had not been emphasised. They discussed other conditions that can cause a pleural mass with rib destruction.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma, Differential Diagnosis.

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