Unusual region for pericardial malignant mesothelioma: cutaneous manifestation in a Turkish woman

Our plain-English summary of Unusual region for pericardial malignant mesothelioma: cutaneous manifestation in a Turkish woman, by M. Günday, H. Erinanç, C. Geredeli (Rare Tumors, 2013).

The study

• Authors: M. Günday, H. Erinanç, C. Geredeli
• Journal: Rare Tumors
• Published: 2013;5(3):e41
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma is a disease that originates from mesenchymal cells. It is related to the occupational or environmental exposure to asbestos. The treatment remains controversial because it is commonly diagnosed at a very late stage, and the prognosis is very poor. In this report, we present a 37-year-old female patient who was admitted with shortness of breath, palpitation and inability to sleep on her back for the previous 10 days. A large pericardial effusion was detected on echocardiography. Pericardiocentesis was performed and the patient's symptoms were alleviated. However, approximately 7 months later, she was readmitted to the clinic with complaints of a mass at the incision site. Pathological examination of the mass yielded a diagnosis of pericardial malignant mesothelioma. Malignant mesothelioma is a rare occurrence, and to our knowledge, there are no reports in the English literature of pericardial malignant mesothelioma local invasion to an incision site.

In plain English

This case report described a 37-year-old Turkish woman who was admitted with 10 days of shortness of breath, palpitations and inability to sleep on her back. Chest X-rays showed an extensive pericardial effusion, a fluid collection around the heart. About 500 mL of bloody fluid was drained through an incision below the breastbone. Testing of the fluid found no cancer cells or infection. About 7 months later she returned with a mass at the incision site. After the mass was removed, microscope and staining tests showed malignant mesothelioma of epithelioid and desmoplastic type. A PET-CT scan showed an active 53×53×76 mm mass reaching the skin beneath the breastbone, a thickened pericardium, and an active enlarged lymph node behind the pancreas. She had no known history of asbestos exposure. The authors suggested she may have been exposed because she lived in a village area of Konya. The authors concluded that they found no earlier reports of pericardial mesothelioma invading locally into an incision site. They also concluded that such masses should be taken seriously even when fluid cytology is negative.

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 37-year-old woman, a lifelong nonsmoker, treated in Turkey (authors based in Ankara and Konya). She presented with a 10-day history of shortness of breath, palpitation and inability to sleep on her back.
• Exposure: No known history of asbestos exposure. The authors suggested possible exposure from her residence in a village area of Konya. No fiber type was identified for this patient.
• Main results:
  • At the first admission, about 500 mL of hemorrhagic pericardial fluid was drained (pericardiocentesis through a midline incision below the sternum).
  • Cytology of the pericardial fluid was negative for malignant cells and for infection.
  • About 7 months later, the patient returned with a mass at the incision site.
  • The removed mass was diagnosed as malignant mesothelioma of epithelioid and desmoplastic type.
  • The tumor cells were strongly positive for calretinin and focally positive for Ber-Ep4 and MOC-31.
  • PET-CT showed increased FDG uptake (SUV max 17.80) in a 53×53×76 mm lobulated mass extending to the skin beneath the sternum, with pericardial thickening.
  • Enlarged lymph nodes with increased FDG uptake were found behind the body of the pancreas.
• The authors' conclusion: The authors found no reports in the literature of pericardial malignant mesothelioma invading locally into an incision site. They concluded that masses should be considered seriously even when pericardial fluid cytology is negative, because early diagnosis is very important.

Topics

Medical terms in this study, explained in our Lexicon: Pericardial, Malignant Mesothelioma, Environmental Exposure, Prognosis, Pericardial Effusion, Pericardiocentesis.

Related studies

• Cutaneous manifestations of malignant mesothelioma of the tunica vaginalis testis — H.J. van der Rhee, W.A. van Vloten, et al. (1983)
• Calcified plaque in the superior portion of the major fissure. An unusual manifestation of asbestos exposure — S.B. Rupp, H. Jolles (1989)
• Cardiac tamponade as the initial manifestation of primary pericardial mesothelioma — M. Stein, A. Neuman, et al. (1995)
• Erionite exposure in North Dakota and Turkish villages with mesothelioma — M. Carbone, Y.I. Baris, et al. (2011)
• Malignant mesothelioma due to environmental exposure to asbestos: follow-up of a Turkish cohort living in a rural area — S. Metintas, M. Metintas, et al. (2002)
• Prognostic significance of Bax and Fas ligand in erionite and asbestos induced Turkish malignant pleural mesothelioma — N. Kokturk, P. Firat, et al. (2005)

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