Solitary (localized) pleural mesothelioma. Report of two cases and review of the literature

Our plain-English summary of Solitary (localized) pleural mesothelioma. Report of two cases and review of the literature, by F.H. Shabanah, S.F. Sayegh (Chest, 1971).

The study

• Authors: F.H. Shabanah, S.F. Sayegh
• Journal: Chest
• Published: 1971;60(6):558-63
• Cited by: 40 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A few of the primary pleural mesotheliomas are benign. These tumors are localized. They can vary greatly in size. The majority are biologically benign lesions. The application of the techniques of tissue culture to the study of such tumors has considerably helped to clarify the origin of these tumors and their relation to the more common diffuse malignant variety. Review of the English literature since 1942 reveals the reporting of approximately 152 cases of localized pleural mesotheliomas in addition to the authors' two cases. The tumor is usually adequately treated by conservative resection or excision except when there is invasion of contiguous structures. The latter requires more radical treatment.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article combined reports of two patients with a review of published cases. The authors described two benign localized (solitary) pleural mesotheliomas from two New Orleans hospitals. Those hospitals' records listed 17 pleural mesothelioma tumors: 13 diffuse malignant mesotheliomas, two large localized tumors that had invaded the chest wall, and these two benign localized tumors. In both patients a tumor growing from the lining covering the lung (visceral pleura) was removed surgically, and both recovered uneventfully. The second patient, a man, had worked in the holds of ships, where the authors wrote there may have been some exposure to asbestos. His x-ray showed some pleural thickening on both sides, and surgery found pleural plaques in the left chest. The authors also reviewed about 152 cases reported in the English literature since 1942. They noted that no link between asbestos and solitary mesotheliomas had been found in that literature, and that no valid conclusion about cause could be drawn from one case. They concluded that the tumor is usually adequately treated by conservative removal unless it has invaded nearby structures.

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 of two patients combined with a review of the English-language literature since 1942
• Who was studied: Two patients with benign localized pleural mesothelioma: a woman (case 1) and a white man (case 2). They came from pleural mesothelioma cases at the New Orleans Veterans Administration Hospital (1950 to 1970) and Charity Hospital (1948 to 1970), which together listed 17 tumors. The review covered approximately 152 published cases since 1942.
• Exposure: Case 2 had worked in the holds of ships, with possible asbestos exposure. No fiber type or dose was given. No asbestos exposure was reported for case 1.
• Main results:
  • Case 1: a firm pedunculated tumor arising from the visceral pleura of the right middle lobe was removed with a small rim of normal lung. Under the microscope it was very cellular, made of spindle cells with abundant collagen fibers. The final diagnosis was benign solitary fibrous pleural mesothelioma.
  • Case 2: a small tumor on the visceral pleura of the left upper lobe was removed with a small wedge of lung. The diagnosis was probably a localized benign fibrous mesothelioma of the visceral pleura, and the patient recovered uneventfully.
  • Case 2: the chest x-ray showed some pleural thickening on both sides.
  • Case 2: at surgery, hyalin pleural plaques were found in the parietal pleura of the left upper chest and over the left hemidiaphragm. A biopsy of the parietal pleura showed fibrous pleuritis.
  • Of the other pleural mesothelioma patients in the two hospitals' records, all were known dead except two: one diagnosed in 1969 was still alive, and one was lost to follow-up.
  • From the published cases, the authors found that the only reliable sign of a malignant tumor appeared to be gross infiltration or invasion of nearby structures such as the chest wall or lung.
  • The authors stated that no link between asbestos exposure and solitary mesotheliomas had been found in the literature. This contrasts with diffuse malignant mesotheliomas.
• The authors' conclusion: The authors concluded that the tumor is usually adequately treated by conservative resection or excision, except when it has invaded nearby structures, which requires more radical treatment. They also gave their opinion that most, if not all, solitary fibrous pleural tumors arise from the surface mesothelium and should be classified as mesotheliomas.
• Limitations the authors state:
  • No valid conclusion about asbestos as a cause could be drawn from a single case.
  • An accurate count of all published cases was difficult because the earlier literature was not uniform, so only cases published since 1942 were included.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• Solitary (localized) fibrous mesothelioma: evidence against mesothelial cell origin — P.A. Dervan, B. Tobin, et al. (1986)
• Solitary (localized) pleural mesothelioma. A light- and electron-microscopic study — T. Kawai, K. Yakumaru, et al. (1978)
• Metastatic pleural mesothelioma presenting with solitary involvement of the tongue: report of a new case and review of the literature — F. Zanconati, A. DelConte, et al. (2003)
• Solitary fibrous tumors of the pleura: a case report and review of the literature — P. Mordenti, R. Di Cicilia, et al. (2013)
• Localized fibrous tumours of the pleura: 15 new cases and review of the literature — M. Suter, S. Gebhard, et al. (1998)
• Localized malignant mesothelioma, an unusual and poorly characterized neoplasm of serosal origin: best current evidence from the literature and the International Mesothelioma Panel — A.M. Marchevsky, A. Khoor, et al. (2020)

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