The antiestrogen tamoxifen in the treatment of recurrent benign cystic mesothelioma

Our plain-English summary of The antiestrogen tamoxifen in the treatment of recurrent benign cystic mesothelioma, by G.S. Letterie, J.L. Yon (Gynecologic Oncology, 1998).

The study

• Authors: G.S. Letterie, J.L. Yon
• Journal: Gynecologic Oncology
• Published: 1998;70(1):131-3
• Type of article: Case report
• Cited by: 48 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Benign cystic mesothelioma is a tumor characteristically found in women during the reproductive years. These tumors are infrequently found after castration or menopause, suggesting some degree of hormonal sensitivity. Such aspects of the tumor suggest a potential role for antiestrogens as medical management and an alternative to radical surgery. We treated a 19-year-old woman with a symptomatic pelvic mass secondary to a recurrent benign cystic mesothelioma 2 years after radical surgery with the antiestrogen tamoxifen. An initial reduction in volume and arrest of growth was followed by stabilization in size and disappearance of symptoms. Therapy was continued for 18 months with no change in the volume of the cystic structure. The patient continued to be asymptomatic. Periodic surveillance with quantitative digital radiography for bone density showed no change in bone mineral density. Serum testing for liver function studies was normal throughout treatment. This case suggests that antiestrogens may have a role in the medical management of these rare estrogen-dependent neoplasms. The initial reduction in size and arrest in growth further suggest extreme sensitivity of this tumor to manipulation of the hormonal milieu. Therapy with the antiestrogen tamoxifen in this setting may provide an option for long-term medical management in cases of symptomatic recurrent cystic mesotheliomas.

In plain English

This case report described one 19-year-old woman with benign cystic mesothelioma (also called multilocular peritoneal inclusion cysts) in the pelvis, reported by authors at Virginia Mason Medical Center in Seattle. The article did not discuss asbestos. Her tumor had been treated with two earlier operations. The second was a right oophorectomy and hysterectomy, after which an assay for estrogen and progesterone receptors gave values of less than 3 and 5 fmol/mg, respectively. About 2 years later the tumor came back. Ultrasound measured the cyst at 5891 cubic centimeters, then 6076 a month later, and 6812 four months after that, when mild painkillers no longer controlled her pain. She refused surgery and took the antiestrogen tamoxifen, 20 mg daily, for 18 months. Within about 4 weeks her pelvic pain was much reduced, and the cyst shrank and then stayed stable. Bone density showed no change compared with age-matched controls, and liver tests stayed normal. The authors concluded that tamoxifen may offer conservative long-term management when this tumor recurs, regardless of hormone receptor status.

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 19-year-old woman with a recurrent benign cystic mesothelioma of the pelvis after two previous operations (left oophorectomy, then right oophorectomy and hysterectomy). Authors are at Virginia Mason Medical Center, Seattle. Dates of treatment are not given.
• Exposure: No asbestos or other environmental exposure is described. The treatment studied was the antiestrogen tamoxifen, 20 mg daily, continued for 18 months.
• Main results:
  • Before tamoxifen, the recurrent cyst volume measured by ultrasound rose from 5891 cubic centimeters, to 6076 one month later, to 6812 four months after that.
  • After about 4 weeks of tamoxifen, the patient's pelvic pain was significantly reduced, and the cyst volume decreased progressively and then stabilized.
  • Bone mineral density in the lumbar spine and left femoral neck showed no change compared with age-matched controls.
  • Liver function tests were normal throughout treatment.
  • After 18 months of therapy the patient remained stable, without complaint and without significant increase in cyst size.
  • The receptor assay reported after the second operation gave estrogen and progesterone receptor values of less than 3 and 5 fmol/mg, respectively.
• The authors' conclusion: The authors concluded that tamoxifen, regardless of estrogen or progesterone receptor status, may offer conservative long-term management when benign cystic mesothelioma recurs.

Topics

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

Related studies

• Pediatric Benign Cystic Peritoneal Mesothelioma — J. Durell, H. Dagash, et al. (2016)
• Remote Recurrence of Benign Multicystic Peritoneal Mesothelioma — C.E. Lee, A. Agrawal (2017)
• Multicystic peritoneal mesothelioma: A short review — C.H. Zhang, J.W. Yu, et al. (2017)
• Peritoneal benign cystic mesothelioma: a case report and review of the literature — S. van Ruth, M.W. Bronkhorst, et al. (2002)
• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)
• Benign cystic mesothelioma of the peritoneum in a male child — Z. Stojsic, R. Jankovic, et al. (2012)

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