Sarcomatoid localised mesothelioma mimicking intrapulmonary synovial sarcoma: a case report and review of the literature

Our plain-English summary of Sarcomatoid localised mesothelioma mimicking intrapulmonary synovial sarcoma: a case report and review of the literature, by A. Teo, C. Hemmings, R. Miller (Pathology, 2010).

The study

• Authors: A. Teo, C. Hemmings, R. Miller
• Journal: Pathology
• Published: 2010;42(2):182-4
• Type of article: Case report, Letter
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter reported one case and reviewed previously reported cases from the English literature. A 66-year-old man had a 35 mm lung tumour removed in 2004 that was diagnosed as intrapulmonary synovial sarcoma. He remained well for 4 years, then developed right-sided pain beside the breastbone and pleural nodules. After further testing, including a genetic test that found no SYT rearrangement in the original tumour, the diagnosis was revised to localised malignant mesothelioma with sarcomatoid features. He had worked as an electrician, going into roof spaces containing asbestos. No fiber type was given. The authors counted 50 confirmed reported cases of localised malignant mesothelioma (44 pleural, 2 pericardial, 4 peritoneal). They noted that in an earlier series of 23 cases by Allen and colleagues, only four had an asbestos history. They estimated 2-year overall survival of approximately 50%, while noting that the number of cases is small. The authors concluded that the original diagnosis was very difficult. They also concluded that the 4-year disease-free interval was consistent with the reported better survival of the localised form compared with diffuse mesothelioma.

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 (letter to the editor) with a review of previously reported cases in the English literature
• Who was studied: one 66-year-old man with a right middle lobe lung lesion, first seen in 2004, with a 30 pack-year smoking history (stopped 12 years earlier); the review covered 50 previously reported cases of localised malignant mesothelioma
• Exposure: occupational: worked as an electrician, which involved going into roof spaces containing asbestos; fiber type not stated
• Main results:
  • The 2004 lung tumour was initially diagnosed as intrapulmonary synovial sarcoma
  • The patient, who received no adjuvant therapy, remained well for 4 years before developing pain and pleural nodules
  • FISH testing found no SYT rearrangement in the original tumour
  • After expert review, the diagnosis was revised to localised malignant mesothelioma with sarcomatoid morphology
  • Review: 50 confirmed cases of localised malignant mesothelioma reported in the English literature (pleural 44, pericardial 2, peritoneal 4)
  • Review: in an earlier series by Allen et al., only four of 23 cases had a history of asbestos exposure
  • Review: the reported data suggested 2-year overall survival of localised malignant mesothelioma of approximately 50%
• The authors' conclusion: The authors concluded that diagnosing sarcomatoid localised mesothelioma in the original tumour was very difficult. They also concluded that the patient's 4-year disease-free interval was consistent with the reported better survival of localised compared with diffuse malignant mesothelioma.
• Limitations the authors state:
  • The number of reported cases of localised mesothelioma is small
  • The recurrence could conceivably have been a second primary tumour rather than the same tumour
  • Differences in survival between reports may partly reflect differing definitions of localised mesothelioma

Topics

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

Medical terms in this study, explained in our Lexicon: Sarcomatoid, Mesothelioma, Synovial Sarcoma.

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• NY-ESO-1 expression in synovial sarcoma and other mesenchymal tumors: significance for NY-ESO-1-based targeted therapy and differential diagnosis — J.P. Lai, P.F. Robbins, et al. (2012)
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• Challenges and controversies in the diagnosis of malignant mesothelioma: Part 2. Malignant mesothelioma subtypes, pleural synovial sarcoma, molecular and prognostic aspects of mesothelioma, BAP1, aquaporin-1 and microRNA — D.W. Henderson, G. Reid, et al. (2013)
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