Solitary malignant mesothelioma of the small intestine: radiological appearances

Our plain-English summary of Solitary malignant mesothelioma of the small intestine: radiological appearances, by N. Gourtsoyiannis, D. Bays, S. Missas, et al (Abdominal Imaging, 1996).

The study

• Authors: N. Gourtsoyiannis, D. Bays, S. Missas, P. Gallis
• Journal: Abdominal Imaging
• Published: 1996;21(3):258-60
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant peritoneal mesothelioma is virtually unknown to feature as a solitary lesion. A patient presented with abdominal pain, weight loss, and melena and underwent enteroclysis, computed tomography, and superior mesenteric arteriography. Sharp angulation, narrowing, and mucosal destruction in a jejunal segment, caused by an encapsulating infiltrative mesenteric mass, were shown. The diagnosis of a malignant peritoneal mesothelioma, localized to the small intestine, was made at histology.

In plain English

This article is a case report about one patient. He was a 45-year-old Caucasian man who worked as a farmer and had no history of asbestos exposure. He was admitted after 9 months of increasing crampy abdominal pain, along with weight loss and episodes of melena (black stools caused by bleeding). Blood tests showed a hemoglobin level of 9.1 g/dl. Enteroclysis, a contrast X-ray of the small intestine, showed narrowing, sharp angulation and fixation of a loop of jejunum 50 cm from the Treitz. CT showed a low-density mass deforming this loop, and an arteriogram showed a mass with many blood vessels. Before surgery, the doctors suggested a malignant tumor of the small intestine. Surgeons removed 30 cm of jejunum together with its mesentery. Tissue testing led to a final diagnosis of solid-type malignant epithelial mesenteric mesothelioma. The tumor had reached the intestinal lining, which the authors called a distinctive feature. The patient developed widespread metastases and died a year later. The authors stated that, to their knowledge, this was the first report showing before surgery a solitary malignant mesothelioma confined to the mesenteric small intestine.

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)
• Who was studied: One 45-year-old Caucasian man, a farmer, admitted with a 9-month history of crampy abdominal pain, weight loss and melena
• Exposure: No asbestos exposure was reported. The patient was a farmer with no history of asbestos exposure.
• Main results:
  • At admission, the patient's hemoglobin level was 9.1 g/dl.
  • Enteroclysis showed segmental narrowing, sharp angulation and fixation of a jejunal loop 50 cm from the Treitz.
  • CT showed narrowing and deformity of a jejunal loop caused by a low-density mass with mild peripheral contrast enhancement.
  • Selective superior mesenteric arteriography showed a hypervascular mass with straightened feeding jejunal branches.
  • Based on the imaging, a malignant tumor of the small intestine was suggested before surgery, with carcinoid tumor, leiomyosarcoma and/or metastatic carcinoma in the differential diagnosis.
  • At laparotomy, a 30 cm segment of jejunum and its mesentery were removed.
  • On immunohistochemistry, the tumor cells were negative for CEA, smooth muscle actin, EMA and desmin, and positive for vimentin and keratin.
  • The final diagnosis was solid-type malignant epithelial mesenteric mesothelioma.
  • The authors described the tumor's penetration to the mucosa as a distinctive feature of this case.
  • After surgery the patient deteriorated, developed widespread metastases and died a year later.
• The authors' conclusion: The authors stated that, to their knowledge, this was the first report demonstrating before surgery a solitary malignant mesothelioma localized to the mesenteric small intestine.

Topics

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

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

Related studies

• A preliminary study of biochemical changes in the rat small intestine following long-term ingestion of chrysotile asbestos — R. Jacobs, K.S. Dodgson, et al. (1977)
• Toxic effect on the rat small intestine of chronic administration of asbestos in drinking water — T.J. Delahunty, D. Hollander (1987)
• Distribution of 6-6(n)-3[H]sucrose and its radiolabeled degradation products from isolated, perfused rat small intestine loops following prolonged ingestion of chrysotile asbestos — R. Jacobs, R.J. Richards (1980)
• The mesotheliomas of the small intestine — M. Paul, G. Panabokke, et al. (1965)
• Malignant pleural mesothelioma presenting as an acute surgical abdomen due to metastatic jejunal perforation — K. Gocho, K. Isobe, et al. (2010)
• Jejunal Perforation by Metastasis of Malignant Pleural Mesothelioma — M.I. Navarro García, A. Sánchez Pérez, et al. (2015)

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