Ultrasonography and computed tomography of peritoneal mesothelioma

Our plain-English summary of Ultrasonography and computed tomography of peritoneal mesothelioma, by H.C. Yeh, A.P. Chahinian (Radiology, 1980).

The study

• Authors: H.C. Yeh, A.P. Chahinian
• Journal: Radiology
• Published: 1980;135(3):705-12
• Cited by: 37 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Eleven patients with malignant peritoneal mesothelioma were examined with ultrasonography. Four of them were also examined with computed tomography (CT). A sheetlike mass was seen in seven patients and a localized irregular mass was seen in four. No nodular or globular masses were seen. Ascites was present in all patients except one, and an omental mass in addition to a peritoneal mass was found in two. Extremely rapid progression of mesothelioma occurred in one patient, and disappearance of mesothelioma and ascites occurred in another. Ultrasonography was, in general, superior to CT in demonstrating peritoneal masses, especially in the presence of ascites.

In plain English

This article described ultrasound imaging in 11 patients with malignant peritoneal mesothelioma, examined over three years at Mount Sinai Hospital, New York. Four also had computed tomography (CT). There were seven men and four women, aged 31 to 74. Eight had tissue specimens taken at laparotomy or laparoscopy. The other three had biopsy-proved malignant pleural mesothelioma, with ascites (abdominal fluid) and peritoneal masses on ultrasound. Six patients had a history of asbestos exposure, which was not further described. Ultrasound showed peritoneal masses in all 11 patients: sheetlike in seven and localized irregular masses in four. No globular masses were seen. Ascites was present in all but one patient, and two also had a large omental mass. One patient with no mass or ascites on a first scan developed extensive peritoneal tumor about two and a half months later and died a month after that. In another patient, the mass and ascites disappeared eight months after chemotherapy. CT showed the mass in three of the four patients scanned. The authors concluded that ultrasound was very useful and that masses were generally less clearly seen with CT, especially when ascites was present.

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 series describing ultrasonography and computed tomography (CT) findings
• Who was studied: 11 patients with malignant peritoneal mesothelioma (7 men, 4 women; ages 31 to 74, average printed as 66) examined at Mount Sinai Hospital, New York, over the three years before publication. Eight had specimens taken by laparotomy or laparoscopy. Three had biopsy-proved malignant pleural mesothelioma with ascites and peritoneal masses on ultrasonography. Four patients also had CT.
• Exposure: Six of the 11 patients had a history of asbestos exposure. Fiber types, jobs and amounts were not described.
• Main results:
  • Ultrasonography showed peritoneal masses in all 11 patients.
  • A sheetlike mass was seen in 7 patients. These ranged from 8 cm in diameter to almost the whole anterior parietal peritoneum, with thickness from 0.6 cm to 5 cm.
  • A localized irregular mass was seen in the other 4 patients, ranging in size from 5 cm to 9 by 7 cm. No globular mass was seen in any patient.
  • Ascites was present in every patient except one.
  • In 2 patients, a large omental mass was present, fused with the peritoneal mass. A liver metastasis was seen in 1 patient.
  • One patient with pleural mesothelioma had no mass or ascites on the first examination. About two and a half months later, extensive peritoneal involvement had developed, and he died one month later.
  • In one patient, both the ascites and the mass disappeared eight months after chemotherapy with Adriamycin and 5-azacytidine.
  • Of the 4 patients who had CT, CT showed peritoneal masses and ascites matching the ultrasound findings in 3. In the fourth, CT showed only the ascites, not the mass.
• The authors' conclusion: The authors concluded that ultrasonography is very useful in patients with peritoneal mesothelioma, because ascites can be detected early and the tumor can be delineated. They found that masses were generally less clearly seen with CT, especially when ascites was present, except in markedly obese patients.
• Limitations the authors state:
  • The authors noted that ultrasound missed an omental tumor in an obese patient with ovarian carcinoma (not part of this series) because of echoes from the abdominal wall, and that similar problems may occur in mesothelioma.
  • The authors noted that adhesions may not be seen on ultrasound when there is little or no ascites.

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: Peritoneal Mesothelioma, Ascites, Mesothelioma.

Related studies

• Cystic appearance of a malignant peritoneal mesothelioma by ultrasonography and computed tomography: a case report — K.W. Preidler, H. Steiner, et al. (1994)
• Peritoneal mesothelioma: the role of computed tomography in diagnosis and follow up — P.J. Guest, R.H. Reznek, et al. (1992)
• Ultrasonography in ascites — H.C. Yeh, B.S. Wolf (1977)
• Preoperative computed tomography does not predict resectability in peritoneal carcinomatosis — J.D. Rivard, W.J. Temple, et al. (2014)
• Overall survival of pseudomyxoma peritonei and peritoneal mesothelioma patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy can be predicted by computed tomography quantified sarcopenia — A. Galan, P. Rousset, et al. (2018)
• A case of malignant peritoneal mesothelioma suggesting the utility of combining double-contrast radiography and endoscopy with computed tomography for diagnosis — H. Saito, S. Hasuda, et al. (2017)

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