van Ruth S, Bronkhorst MWGA, van Coeverden F, Zoetmulder FAN. Peritoneal benign cystic mesothelioma: a case report and review of literature. Eur J Surg Oncol 2002; 28(2): 192-5

Our plain-English summary of van Ruth S, Bronkhorst MWGA, van Coeverden F, Zoetmulder FAN. Peritoneal benign cystic mesothelioma: a case report and review of literature. Eur J Surg Oncol 2002; 28(2): 192-5, by K. Sethna, F. Mohamed, P.H. Sugarbaker (European Journal of Surgical Oncology, 2002).

The study

• Authors: K. Sethna, F. Mohamed, P.H. Sugarbaker
• Journal: European Journal of Surgical Oncology
• Published: 2002;28(8):897
• Type of article: Comment, Letter
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the authors responded to a case report by van Ruth and colleagues on peritoneal benign cystic mesothelioma. They argued that calling the disease 'benign' cystic mesothelioma is inaccurate. They described their own experience with five patients who had cystic mesothelioma by histopathology, managed over a 10-year span at the Washington Hospital Centre, Washington Cancer Institute, USA. In one of these patients the supposedly benign tumor underwent transition into an invasive, lymph node positive, malignant mesothelioma. One patient came to them without prior surgery. The other four had undergone prior 'complete debulking' and developed documented tumour progression and increasing pain, and three of them required continuous narcotics for pain. The authors reported that the tumour rarely resulted in metastatic disease but was locally aggressive and had a high likelihood of recurrence. They suggested that microscopic residual disease probably remained widely disseminated after debulking surgery. Drawing on their experience treating pseudomyxoma peritonei, they had treated their cystic mesothelioma patients with cytoreductive surgery combined with perioperative intraperitoneal chemotherapy, with 4-year follow-up and no evidence of recurrence to date. They recommended hyperthermic intraperitoneal cisplatin and doxorubicin, followed by five days of early postoperative intraperitoneal taxol, together with complete cytoreduction, as a curative approach. They also stated that the disease should be renamed.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor, not a research study. Three authors from surgical oncology at the Washington Cancer Institute, USA, responded to a case report by van Ruth and colleagues on 'benign cystic mesothelioma' of the peritoneum (the abdominal lining). They described five of their own patients with cystic mesothelioma, managed over 10 years. In one, the supposedly benign tumor became an invasive, lymph node positive, malignant mesothelioma. Four had earlier 'complete debulking' surgery, then documented tumour progression and increasing pain. Three needed continuous narcotic pain medicine. The writers said the cause of recurrence is not established. They reported treating patients with surgery plus chemotherapy given into the abdomen around the time of surgery. They reported 4-year follow-up with no evidence of recurrence to date, without saying how many patients were treated. The authors concluded that the 'benign' label is inaccurate. As a curative approach they recommended complete cytoreduction (surgery removing all visible tumor) with heated cisplatin and doxorubicin perfused into the abdomen, then five days of taxol into the abdomen early after surgery. The letter does not mention asbestos.

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: Letter to the editor commenting on a published case report, describing the letter writers' own experience with five patients
• Who was studied: Five patients with cystic mesothelioma of the peritoneum managed by the letter writers' group (Washington Hospital Centre, Washington Cancer Institute, USA) over a 10-year period
• Exposure: Not an exposure study. Asbestos and other causes are not discussed. The letter concerns naming and treatment of cystic mesothelioma.
• Main results:
  • In one of the five patients, the supposedly benign tumor became an invasive, lymph node positive, malignant mesothelioma
  • One of the five patients came to the group without prior surgery
  • The other four patients had prior 'complete debulking' and developed documented tumour progression and increasing pain
  • Three of these patients required continuous use of narcotics for pain from the disease
  • The writers stated that, from long-term follow-up, the disease is locally aggressive and has a high likelihood of recurrence
  • With combined cytoreductive surgery and perioperative intraperitoneal chemotherapy, the writers reported 4-year follow-up and no evidence of recurrence to date. The number of patients treated this way is not stated.
• The authors' conclusion: The authors concluded that the name 'benign' cystic mesothelioma should be changed and treatment modified. As a curative approach they recommended complete cytoreduction together with hyperthermic intraperitoneal cisplatin and doxorubicin, followed by five days of early postoperative intraperitoneal taxol.
• Limitations the authors state:
  • The writers state that the cause of recurrence has not been established. Their explanation (widespread microscopic residual disease) is described as likely, not proven.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Histopathology, Malignant Mesothelioma, Cytoreductive Surgery, Chemotherapy, Cisplatin, Doxorubicin.

Related studies

• Peritoneal benign cystic mesothelioma: a case report and review of the literature — S. van Ruth, M.W. Bronkhorst, et al. (2002)
• Benign cystic mesothelioma associated with ipsilateral renal agenesis: a case report and review of literature — D. Murro, A. Harbhajanka, et al. (2014)
• Pediatric Benign Cystic Peritoneal Mesothelioma — J. Durell, H. Dagash, et al. (2016)
• Benign cystic mesothelioma of the peritoneum in a child-case report and review of the literature — V.C. Shakya, C.S. Agrawal, et al. (2011)
• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)
• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)

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