Synchronous occurrence of benign mesothelioma and adenomatoid tumor of uterus: A case report and review of literature

Our plain-English summary of Synchronous occurrence of benign mesothelioma and adenomatoid tumor of uterus: A case report and review of literature, by P.R. Shen, J. Cen, X.Q. Qian, et al (Medicine, 2019).

The study

• Authors: P.R. Shen, J. Cen, X.Q. Qian, Y.M. Shen, X.D. Cheng, X.Y. Wan
• Journal: Medicine
• Published: 2019;98(20):e15746
• Type of article: Case report, Review
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Synchronous occurrence of benign cystic mesothelioma and adenomatoid tumor of uterus (UAT) are very rare and few cases have been published in the English literature. They are easily misdiagnosed as malignant by clinicians, due to the lack of reports.

Patient Concerns: A case of benign mesothelial combined with uterus adenomatoid tumor (UAT) in a 48-year-old Chinese woman was reported. Our patient presented with abdominal pain and surgery showed a large subserous mass (12.0 × 11.4 × 9.8 cm) combined with a small intramural solid nodule (2.0 × 1.0 × 1.0 cm), and multiple minute neoplastic growth on the ovary.

Diagnosis: Due to the patient's symptoms, pathological findings, she was diagnosed with synchronous occurrence of benign mesothelioma and UAT.

Interventions: We treated her with a total hysterectomy and bilateral adnexectomy.

Outcomes: The patient is now in stable condition, without any signs of recurrence during 1 year of follow-up.

Lessons: Most mesotheliomas are malignant, synchronous occurrence of benign mesothelioma and UAT are extremely rare. And they are often misdiagnosed as malignancy by clinicians. Our case report can improve the awareness of the disease and avoid excessive treatment.

In plain English

This article is a case report with a short review of earlier published cases. The authors described a 48-year-old Chinese woman admitted with one month of abdominal pain. She had a history of tubal ligation and denied asbestos exposure. Ultrasound and CT scans pointed to a degenerating uterine fibroid (myoma). At surgery, the surgeons found a mass about 12 cm across behind the uterus, attached to it by a stalk, and tiny growths on the surface of the left ovary. She had a total hysterectomy and bilateral adnexectomy (removal of the uterus and of both ovaries and fallopian tubes). Final pathology showed a localized, well-differentiated benign mesothelioma. The ovarian growths were thought to be spread of the mesothelioma. A separate nodule of about 2 cm in the uterine wall was an adenomatoid tumor, another rare benign tumor. She received no chemotherapy and had no signs of recurrence during 1 year of follow-up. The authors also tabulated 4 previously reported cases of benign mesothelioma of the uterus. They concluded that the two tumors occurring together are extremely rare and easily misdiagnosed as cancer.

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 with review of literature
• Who was studied: One 48-year-old Chinese woman (gravida 4, para 2) admitted with abdominal pain to a hospital affiliated with Women's Hospital, School of Medicine, Zhejiang University, China; dates of care not stated
• Exposure: No asbestos exposure reported: the patient denied asbestos exposure. Her only noted risk-factor history was a previous tubal ligation.
• Main results:
  • Before surgery, imaging was read as a degenerating uterine myoma (CT: myoma fatty degeneration)
  • At surgery there was a mass about 12 cm in diameter behind the uterus, attached to the uterus by a pedicle
  • Final pathology diagnosed a localized well-differentiated benign mesothelioma
  • On immunohistochemistry, Calretinin, D2-40 and CK were positive, and p53 and EMA were negative
  • The tiny growths on the ovary surface were thought to be involvement by the mesothelioma
  • A separate nodule about 2 cm in diameter in the uterine muscle wall was an adenomatoid tumor
  • The patient received no postoperative chemotherapy and showed no signs of recurrence during 1 year of follow-up
  • In their literature review, the authors added 4 previously reported cases of benign mesothelioma to 6 cases (benign mesothelioma combined with uterine adenomatoid tumor) summarized by Hatano et al in 2011
• The authors' conclusion: The authors concluded that benign mesothelioma and uterine adenomatoid tumor occurring together are extremely rare and are easily misdiagnosed as malignancy by clinicians, and that understanding these diseases can improve the skills of clinicians and pathologists.
• Limitations the authors state:
  • The authors stated that more cases are needed to know whether her tubal ligation was a direct factor in the disease

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Adenomatoid Tumor, Bilateral.

Related studies

• Combined adenomatoid tumor and well differentiated papillary mesothelioma of the omentum — Y. Hatano, Y. Hirose, et al. (2011)
• Composite multicystic mesothelioma and adenomatoid tumour of the uterus: different morphological manifestations of the same process? — J.K. Chan, M.H. Fong (1996)
• TRAF7 mutations and immunohistochemical study of uterine adenomatoid tumor compared with malignant mesothelioma — H. Itami, T. Fujii, et al. (2021)
• Uterine adenomatoid tumors confirmed by immunohistochemical staining — M. Irikoma, K. Takahashi, et al. (2001)
• Immunohistochemical evidence of the mesothelial histogenesis of a uterine adenomatoid tumor — Y. Satoh, M. Hiraguchi, et al. (1998)
• Adenomatoid tumor of the pleura — H. Minato, T. Nojima, et al. (2009)

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