Sarcomatoid Mesothelioma With New Pancreatic Lesions Presenting As Acute Pancreatitis: A Case Report

Our plain-English summary of Sarcomatoid Mesothelioma With New Pancreatic Lesions Presenting As Acute Pancreatitis: A Case Report, by F. Al-Moussally, F. Alamin, S. Khan, et al (Curēus, 2024).

The study

• Authors: F. Al-Moussally, F. Alamin, S. Khan, P.K. Gopalan
• Journal: Curēus
• Published: 2024;16(7):e64088
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Sarcomatoid mesothelioma is a rare, aggressive malignancy that usually follows asbestos exposure. It is the least common subtype of mesotheliomas, following epithelial and biphasic subtypes. Pleural mesothelioma can metastasize, with the liver, kidneys, adrenal glands, and opposite lungs being the most commonly reported sites for metastasis. Metastasis of the pancreas is extremely rare, which is why the authors of this case report intend to present the case of a 78-year-old male who was found to have acute pancreatitis, most likely secondary to metastatic lesions.

Copyright © 2024, Al-Moussally et al.

In plain English

This was a case report about one patient: a 78-year-old man with a remote history of possible occupational asbestos exposure who had recently been diagnosed with metastatic sarcomatoid mesothelioma of the pleura. Seven weeks earlier, a biopsy of a chest wall mass had favored sarcomatoid mesothelioma. He then had the mass removed and received palliative radiation. He came to the emergency department with three days of abdominal pain, nausea and vomiting. His lipase, a pancreatic enzyme, was greater than 1020 U/L (reference range 8 to 78 U/L). A CT scan showed possible mild pancreatitis with new masses in the neck and tail of the pancreas. It also showed worsening cancer spread to the peritoneum, the muscles beside the spine, and bone. The authors described the pancreatitis as likely caused by these metastatic lesions. He was treated with no food at first, intravenous fluids and pain control. He improved and went home with plans to start nivolumab and ipilimumab once the acute pancreatitis resolved. The authors concluded that the pancreas is a potential site of spread for pleural sarcomatoid 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 (one patient)
• Who was studied: One 78-year-old man with diabetes, hyperlipidemia, benign prostatic hypertrophy, hypertension and allergic rhinitis, recently diagnosed with metastatic sarcomatoid mesothelioma. The article does not state where or when he was treated.
• Exposure: A remote history of possible occupational asbestos exposure. No job, fiber type or amount is described.
• Main results:
  • Seven weeks before the hospital visit, a biopsy of a chest wall mass was consistent with a malignant spindle cell tumor, favoring sarcomatoid mesothelioma.
  • After the biopsy he had the chest wall mass resected and received palliative radiation therapy.
  • He presented with three days of abdominal pain, nausea and vomiting.
  • His lipase was greater than 1020 U/L (reference range 8-78 U/L).
  • CT of the abdomen and pelvis showed possible mild pancreatitis with new masses in the pancreatic neck and tail.
  • CT also showed worsening metastatic disease in the peritoneum, paraspinal muscle and bone.
  • The authors described the acute pancreatitis as likely secondary to metastatic lesions in the neck and tail of the pancreas.
  • He was treated with no diet at first, intravenous fluids and pain control.
  • He slowly improved and was discharged. The plan was to start nivolumab and ipilimumab once the acute pancreatitis resolved.
• The authors' conclusion: The authors concluded that the pancreas is a potential metastasis site for pleural sarcomatoid mesothelioma. They also wrote that pancreatic metastasis is a differential diagnosis for acute pancreatitis.

Topics

Medical terms in this study, explained in our Lexicon: Sarcomatoid, Mesothelioma, Asbestos Exposure, Biphasic Mesothelioma, Pleural Mesothelioma, Metastasis.

Related studies

• An immunohistochemical comparison of two TTF-1 monoclonal antibodies in atypical squamous lesions and sarcomatoid carcinoma of the lung, and pleural malignant mesothelioma — S. Klebe, A. Swalling, et al. (2016)
• Malignant pleural mesothelioma presenting as an acute surgical abdomen due to metastatic jejunal perforation — K. Gocho, K. Isobe, et al. (2010)
• Malignant pleural mesothelioma presenting as acute empyema with severe leukocytosis — K. Matsuoka (2014)
• Sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor with no previous asbestos exposure — Y.A. Notue, U.I. Mbessoh, et al. (2020)
• Pleural calcification in pancreatitis demonstrated by computed tomography — G.M. Bydder, L. Kreel (1981)
• Occupational exposures and pancreatic cancer: a meta-analysis — I.A. Ojajärvi, T.J. Partanen, et al. (2000)

Browse more research in Curēus, or return to medical research.