What caused gastrointestinal bleeding in a woman with a history of pleural mesothelioma? Metastatic diffuse epithelioid mesothelioma

Our plain-English summary of What caused gastrointestinal bleeding in a woman with a history of pleural mesothelioma? Metastatic diffuse epithelioid mesothelioma, by F. Iafrate, S. Sibio, P. Sammartino, et al (Gut, 2010).

The study

• Authors: F. Iafrate, S. Sibio, P. Sammartino, M. Ciolina, A. Pichi, F. Accarpio, A. Ciardi, C. Hassan, M. Di Seri, S. Quadrini, A. Laghi, R. Passariello, A. Di Giorgio
• Journal: Gut
• Published: 2010;59(5):644, 690
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a case report published as an editor's quiz in the journal Gut by doctors in Rome, Italy. It described a 72-year-old white woman admitted to a university hospital with malaria. Two years earlier she had been diagnosed with pleural mesothelioma. It was treated with surgery on the left side of the chest, which included removing part of the chest wall and diaphragm, followed by four courses of chemotherapy. As the malaria was almost resolved, she developed severe anaemia (haemoglobin 7.2 g/dl, against a normal value of 13.0 g/dl) and a raised white blood cell count, so doctors searched for hidden bleeding. A CT scan showed a very large polyp-like growth in the ascending colon, with enlarged nearby lymph nodes but no sign that the mesothelioma had returned in the chest. Colonoscopy found a bleeding growth in the right colon. Biopsy was reported as a primary colon adenocarcinoma, which was removed surgically. The article then asked readers for the 'real diagnosis'. The answer, printed on page 690, was not in the text provided. The text 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: case report (editor's quiz)
• Who was studied: one 72-year-old white woman admitted to a university hospital in Rome, Italy, with malaria, who had a history of pleural mesothelioma
• Main results:
  • The patient had pleural mesothelioma diagnosed 2 years earlier, treated by left thoracotomy with chest wall and diaphragm resection followed by four courses of systemic chemotherapy
  • As the malaria was almost resolved, the patient developed severe anaemia (haemoglobin 7.2 g/dl, normal value 13.0 g/dl) and leucocytosis, prompting a search for occult bleeding
  • CT showed a huge polypoid lesion in the ascending colon with locoregional lymphadenopathy but no evidence of pleural relapse
  • Colonoscopy found a bleeding polypoid lesion in the right colon. Standard histopathology of biopsies diagnosed a primary colon adenocarcinoma, which was removed by right hemicolectomy and regional lymphadenectomy
• The authors' conclusion: Not given in the provided text. The article asks 'What is the real diagnosis?' and refers readers to page 690 for the answer, which is missing.

Topics

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

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

Related studies

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• Value of the mesothelium-associated antibodies thrombomodulin, cytokeratin 5/6, calretinin, and CD44H in distinguishing epithelioid pleural mesothelioma from adenocarcinoma metastatic to the pleura — P.M. Cury, D.N. Butcher, et al. (2000)
• Epithelioid malignant mesothelioma metastatic to the skin: A case report and review of the literature — R.E. Ward, S.A. Ali, et al. (2017)
• Metastatic proximal epithelioid sarcoma in pleural effusion: cytopathologic findings and differential diagnosis — H. Guan, F. Haque, et al. (2013)
• Malignant peritoneal mesothelioma in a 76-year-old woman with a history of asbestos fiber ingestion — P. Van Kesteren, J. Bulten, et al. (2004)
• Left diaphragmatic hernia complicated by perforation of an intrathoracic gastric ulcer into the aorta: report of a case — Y. Saito, Y. Yamakawa, et al. (2000)

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