Cases Of Malignant Mesothelioma Research Articles

An Autopsy Case of Malignant Pleural Mesothelioma Associated with Nephrotic Syndrome

A 64-year-old man who had been exposed to asbestos was referred to our hospital for a detailed examination of left pleural effusion. A laboratory examination of the urine and blood revealed nephrotic syndrome. A thoracoscopic examination did not yield a definitive diagnosis. Twenty months later, a left pleural tumor became apparent, and the patient died of respiratory failure and cachexia. An autopsy revealed epithelioid malignant pleural mesothelioma. The glomeruli appeared normal under light microscopy. A review of the English literature revealed only three reports of malignant mesothelioma associated with minimal-change nephrotic syndrome. The natural course of malignant mesothelioma with nephrotic syndrome has not been previously reported.

Case of Malignant Mesothelioma of the Peritoneum and Pleura

Malignant mesothelioma is a rare aggressive tumor and arises from mesothelial cells in the pleural, peritoneal and pericardial cavities. Median survival is -1 year and the incidence is approximately 0.7 per million persons, and is increasing annually in Korea. It is difficult to diagnose malignant mesothelioma because of nonspecific symptoms, signs and laboratory findings. It needs to be confirmed by histological examination and immunohistochemistry. There is no case report of malignant mesothelioma of the peritoneum and pleura in Korea. We report a rare case of malignant mesothelioma with simultaneous involvement of the peritoneum and pleura in a 75-year-old man without evidence of asbestos exposure. (Korean J Med 2014;87:756-760)

A Case of Malignant Mesothelioma Derived from Scrotum

A Case of Malignant Mesothelioma Derived from Scrotum

Guidelines for the diagnosis and treatment of malignant pleural mesothelioma.

Malignant Pleural Mesothelioma (MPM), the asbestos-induced neoplasm originating in the mesothelial lining of the lung cavities represents significant diagnostic and therapeutic challenges for clinicians in Australia. Very seldom diagnosed prior to the advent of widespread asbestos mining in the early to midtwentieth century, it has sharply risen in incidence over the last five decades. According to the most recent Australian Institute of Health and Welfare data, there were 666 cases of malignant mesothelioma diagnosed in Australia in 2009 and around 90% of them originated in the pleura.

Malignant Pleural Mesothelioma Presenting as Acute Empyema with Severe Leukocytosis

Five months after the treatment for acute empyema, a 75-year-old woman was referred to our hospital because of marked elevation of the white blood cell (WBC) count and C-reactive protein (CRP) level, and a right pleural mass detected by chest computed tomography. At this time, the WBC count and CRP level had increased to 60400/microl and 18.2 mg/dl, respectively. We performed biopsy and the tumor was diagnosed as sarcomatoid malignant pleural mesothelioma. Malignant pleural mesothelioma occasionally presents the symptoms and findings like an acute empyema. We demonstrated the case of malignant pleural mesothelioma which had presented the symptoms and laboratory findings very similar to acute empyema and had treated as acute empyema.

Tomotherapy in the Treatment of Malignant Pleural Mesothelioma

To analyze retrospectively 47 cases of malignant pleural mesothelioma (MPM) treated during the period 2008-2012 using helical tomotherapy (HT) either to confirm the role of adjuvant radiation therapy after extra-pleural pneumonectomy (EPP) or to define the role of radiation therapy after pleurectomy/decortication (P/D) or medical/surgical biopsy (B).

Malignant Mesothelioma, Hypoalbuminaemia and the Effect of Carboplatin/Pemetrexed on Survival

AimsThe incidence of malignant mesothelioma in the UK is increasing. The aim of this study was to determine the prognostic factors and assess the effect of carboplatin/pemetrexed chemotherapy on survival. Materials and methodsCases of malignant mesothelioma diagnosed between 1998 and 2011 were stratified by year of diagnosis. Factors affecting survival were assessed by Cox's proportional hazards regression. ResultsIn total, there were 202 new cases of malignant mesothelioma between 1998 and 2011. The age-standardised rate (95% confidence interval) increased from 2.84 (2.06–3.60) to 4.44 (3.50–5.4); P = 0.025. Chemotherapy use has increased since 2006: 52% versus 34% (P = 0.007). The median survival (interquartile range) by year diagnosed was 9 (4.0–21.9) versus 10 (3.8–20.1) months for 1998–2005 versus 2006–2011. Independent predictors of survival [hazard ratio (95% confidence interval)] were: histology, sarcomatoid 2.22 (1.49–3.31) and unspecified non-epithelioid 1.50 (1.06–2.14); Eastern Cooperative Oncology Group performance status ≥3 2.86 (1.64–5.00); hypoalbuminaemia 2.07 (1.47–2.92), carboplatin/pemetrexed chemotherapy 0.56 (0.38–0.80). ConclusionThe incidence of mesothelioma is increasing. Adverse prognostic factors include non-epithelioid histology, performance status and hypoalbuminaemia. Overall survival has not improved significantly, but treatment with carboplatin/pemetrexed chemotherapy is associated with a significant survival benefit.

200 The contribution of surveillance data to occupational burden of disease studies

ObjectivesTo explore methodological issues related to the use of surveillance data in burden of disease studies.Methods and ResultsBurden of disease methodologies generally rely on the calculation of population attributable fraction...

Diffuse malignant peritoneal mesothelioma

Mesothelioma often originates in the pleura and less frequently in the peritoneum. This article describes a rare case of diffuse malignant peritoneal mesothelioma in a 54-year-old male construction worker who was admitted to our hospital with a 2-month history of progressive abdominal distention. Abdominal computed tomography revealed extensive peritoneal nodularity and omental cake along with massive ascites. Imaging findings initially suggested peritoneal carcinomatosis, primary peritoneal carcinoma, and tuberculous peritonitis. Laparoscopic biopsy of the omentum and peritoneum confirmed the diagnosis of malignant peritoneal mesothelioma of epitheloid type. Although systemic chemotherapy was administered, no tumor regression was found. The patient finally died of nosocomial infection.

Primary Pleural Malignant Mesothelioma with Delayed Metastasis to the Piriform Sinus: Report of a Case

Piriform sinus tumors are uncommon and silent lesions. Their prognosis is poor because these tumors are usually not detected until they have reached an advanced stage. Almost all piriform sinus cancers are primary squamous cell carcinomas; other primary and metastatic tumors of the hypopharynx are exceedingly rare. One of the rare tumors in the laryngopharyngeal area is sarcomatoid carcinoma, which is an unusual type of squamous cell carcinoma. Another uncommon malignant tumor that is histologically similar to sarcomatoid carcinoma is malignant mesothelioma, which is a rare form of lung carcinoma. The macroscopic appearance and histologic characteristics of sarcomatoid carcinoma and malignant mesothelioma are so similar that differentiation is usually achieved by immunohistochemical examination. To the best of our knowledge, no case of primary or metastatic laryngohypopharyngeal malignant mesothelioma has been previously reported in the literature. In this article, we describe a case of isolated malignant mesothelioma of the piriform sinus that resembled a sarcomatoid carcinoma in a 50-year-old man with a history of lung mesothelioma.

総説 原発性心膜悪性中皮腫の1例と本邦集計例(118例)の検討

総説 原発性心膜悪性中皮腫の1例と本邦集計例(118例)の検討

Abstract 300: CTGF is overexpression in asbestos-induced malignant mesothelioma and promotes beta-catenin-T-cell factor/Lef signaling.

Abstract It is a well-known fact that malignant mesothelioma is primarily caused by the exposure to asbestos. Due to the widespread use of asbestos, cases of malignant mesothelioma are increasing at a dramatic rate. Histopathological examinations have revealed different subtypes of malignant mesothelioma. Based on cellular morphology, it is classified into epithelial (EM), sarcomatous (SM) and biphasic (BM) (containing a mixture of epithelial and sarcomatous cells) subtypes. Although sarcomatous mesothelioma is not as common as epithelial mesothelioma, it is recognized as the most aggressive type of malignant mesothelioma and patients diagnosed with this type of mesothelioma usually have a remarkably short survival period. Driven by the interest to know what are the molecular mechanisms underlying the relatively more aggressive phenotype of sarcomatous mesothelioma, we have initiated our study. From the microarray results, we have singled out a candidate gene (connective tissue growth factor, CTGF) whose expression is significantly increased in SM samples compared to the EM and normal control. We found CTGF regulated mesothelioma cells, especial SM cells proliferation, migration, invasion via activating β-catenin-T-cell factor/Lef signaling pathway. Mesothelioma cells decreased proliferation, migration, invasion after knockdown CTGF. We injected mesothelioma cells or CTGF-knockdown mesothelioma cells into nude mice. The tumor size of CTGF-knockdown mesothelioma injection is significant smaller than non-treated mesothelioma, especially in SM. We also found a causal association between high CTGF expression and the poor prognosis of sarcomatous mesothelioma and that the underlying molecular mechanism is related to the promotion of EMT (epithelial-mesenchymal transition) by CTGF. Many EMT regulators including Slug, Snail and Twist have been activated when over-expressed CTGF in EM. Conversely, the MET also is found when knockdown CTGF in SM. Our study is expected to have a great impact by offering novel therapeutic targets which are urgently needed at present. Our preliminary data appears to be very promising and we are highly confident that through the manipulation of our candidate gene, we will be able to at least greatly reduce the malignancy of sarcomatous subtype of mesothelioma and extend patient's lifespan, if not fully cure it. Citation Format: Li Jiang. CTGF is overexpression in asbestos-induced malignant mesothelioma and promotes beta-catenin-T-cell factor/Lef signaling. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 300. doi:10.1158/1538-7445.AM2013-300

Collision tumors of hepatocellular carcinoma and malignant peritoneal mesothelioma

We report a case of synchronous hepatocellular carcinoma (HCC) and malignant peritoneal mesothelioma (MM-per). A 56-year-old man with no past history of asbestos exposure, chronic viral hepatitis, or alcoholic liver injury was admitted to our hospital with left flank pain and abdominal tumor. Partial hepatectomy, splenectomy, partial diaphragm resection, and partial gastrectomy were performed. The tumor in the lateral segment of the liver was gray to white, massive in appearance, and contained focal bile-producing nodules and extensive fibrous firm lesion. It had directly invaded the spleen and diaphragm. Liver cirrhosis was not found. The peritoneum contained multiple small nodules especially around the diaphragm, which mimicked carcinoma dissemination. After histological examination, the liver tumor was diagnosed as HCC. It had trabecular and scirrhous patterns and positive immunoreactivities for Hep-Par-1 and α-fetoprotein. The peritoneal nodules were diagnosed as MM-per, epithelioid type, with positive immunoreactivities for calretinin and cytokeratin 5/6. The two tumors collided around the diaphragm. Cases of MM synchronous with other primary malignant tumors have been reported, but most had a history of asbestos exposure unlike the present case. The carcinogenic background was unclear for two tumors in this case. This is an extremely rare and valuable case.

The assessment of the malignant mesothelioma cases and environmental asbestos exposure in Sivas province, Turkey

One of the most significant diseases related to environmental asbestos exposure is malignant mesothelioma (MM). Sivas province is located in the Central Anatolia where asbestos exposure is common. We aimed to study clinical, demographical and epidemiologic features of the patients with MM in Sivas, along with the history of asbestos exposure. In total, 219 patients with MM who were diagnosed in our hospital between 1993 and 2010 were retrospectively analyzed in terms of demographical and clinical features. Rock, soil and house plaster samples were taken from the habitats of those patients and were evaluated with optical microscopy and X-ray diffraction methods. The age of the patients ranged between 18 and 85years. The male-to-female ratio was 1.4:1. Most of the patients confirmed an asbestos exposure history. The most frequent symptoms of the patients were chest pain (60%) and dyspnea (50%). The gap between the start of first symptoms and the diagnosis date was approximately 4months in average. The plaster materials used in most of the houses were made up of mainly carbonate and silicate minerals and some chrysotile. Ophiolitic units contained fibrous minerals such as serpentine (clino+orthochrysotile) chiefly and pectolite, brucite, hydrotalcite and tremolite/actinolite in smaller amounts. MM is not primarily related to occupational asbestos exposure in our region, and hence, environmental asbestos exposure may be indicted. Yet, single or combined roles and/or interactions of other fibrous and non-fibrous minerals in the etiology of MM are not yet fully understood and remain to be investigated.

Peripheral lymphadenopathy as the initial manifestation of malignant mesothelioma in a child

Peripheral lymphadenopathy is a rare presentation in malignant mesothelioma. We describe a unique case of malignant mesothelioma arising in an 11-year-old boy, for whom peripheral lymphadenopathy was the initial manifestation of the disease. The final diagnosis was confirmed by a broad panel of immunohistochemical markers. Literature review disclosed only 2 cases in childhood that initially presented with peripheral lymphadenopathy. Pathologists should be aware of this rare biologic behavior of malignant mesothelioma to reach the correct and prompt diagnosis.

Value of glut-1 and koc markers in the differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and pulmonary adenocarcinoma

Malignant mesothelioma (MM) is a primary malignant tumor developing from mesothelial cells lining the serosal surfaces and particularly the pleura, and has a very poor prognosis. It may display a variety of histological patterns and has a wide spectrum of cytomorphological characteristics, causing problems in its differential diagnosis from lung adenocarcinomas and sometimes from benign mesothelial proliferations. Immunohistochemical examination is the most useful method for this distinction. In our study, we aimed to determine the value of glucose transporter isoform-1 (GLUT-1) and K homology domain-containing protein (KOC) markers in the differential diagnosis of reactive mesothelial hyperplasia, malignant mesothelioma and lung adenocarcinoma. Our study included 30 samples of malignant mesothelioma, 30 samples of pulmonary adenocarcinoma and 30 samples of reactive mesothelial hyperplasia selected from the archives of the Fırat University Hospital's Pathology Department Laboratory. The samples were applied GLUT-1 and KOC markers by immunohistochemistry and the place of these markers in the differential diagnosis was examined. GLUT-1 was found positive in 80% of malignant mesothelioma cases, 83.3% of adenocarcinoma cases and 6.6% of reactive mesothelial hyperplasia cases. KOC was positive in 83.3% of malignant mesothelioma cases, 76.6% of adenocarcinoma cases and 46.6% of reactive mesothelial hyperplasia cases. There was no statistically significant difference between malignant mesothelioma and lung adenocarcinoma cases in terms of the diffuseness and intensity of staining with GLUT-1, whereas a significant difference was established when these groups were compared with reactive mesothelial hyperplasia cases. However, the KOC staining diffuseness and intensity results were similar to those obtained with GLUT-1. In conclusion, GLUT-1 and KOC markers do not differentiate malignant mesotheliomas from pulmonary adenocarcinomas but can be useful in differentiating reactive mesothelial hyperplasia from malignant mesothelioma and lung adenocarcinoma.

Malignant Mesothelioma of the Pericardium: A Report of Two Different Presentations

Malignant mesothelioma of the pericardium is a rare and fatal condition that clinicians should be aware of due to its variability of clinical manifestation. The diagnosis may be delayed as a result of delayed treatment. Here, we report two cases of malignant pericardial mesothelioma with two different clinical aspects: cardiac tamponade and mimic tuberculous pericarditis. Both patients: may have indirect exposure to asbestos. Despite chemotherapy, both patients died at 2 weeks and 3 months after the diagnosis. Malignant mesothelioma of the pericardium is fatal, has a variety of presentation, and may not be related to asbestosis exposure.

Malignant peritoneal mesothelioma presenting umbilical hernia and Sister Mary Joseph’s nodule

Malignant peritoneal mesothelioma is a rare aggressive tumor of the peritoneum. An increasing number of malignant mesothelioma cases have been reported in recent years. We report here a very rare case of malignant peritoneal mesothelioma with both umbilical hernia and umbilical metastasis which is also called Sister Mary Joseph's nodule. We performed laparoscopy which showed specific laparoscopic findings, and the pathological findings of the biopsy specimen led to the diagnosis. This case was associated with umbilical hernia which could be induced by massive ascites. A newly developed abdominal hernia should be noted as a primary symptom of malignant peritoneal mesothelioma, as shown in the present case.

A case of malignant pleural mesothelioma without notion of exposure to asbestos

Malignant pleural mesothelioma (MPM) is a primary cancer of the pleura which is rare without exposure to asbestos. We report a case of MPM. Through this case the radiological and pathological progressive clinical features of this disease have been studied. A 58-year female patient without exposure to asbestos, presented with right chest pain, dyspnea, and cough. Examination revealed a pleural effusion syndrome. Puncture brought a sero-hematic liquid with leucocytes /mm3 1240 and 1010000 hematies /mm3. CT scan showed an irregular pleural thickening 12 cm on average. Thoracoscopy had revealed a mass of the cerebral basal parietal pleura and nodular and ne- crotic lesions on the visceral pleural. Histology and immunohistochemistry confirmed MPM, expressing AE1 / AE3 and cytokeratin 5/6. The staging showed no abdominal and brain secondary location. She received pleurodesis followed by chemotherapy. The evolution was marked by the death after 18 months of palliative care. MPM is a primary tumor of the pleura, very aggressive; the prognosis remains poor despite recent advances in the management. Our case illustrates the diagnostic difficulties and delay in the absence of the notion of exposure to asbestos.

An unusual case of paratesticular mesothelioma on the site of previously excised epididymal adenomatoid tumour

INTRODUCTIONMalignant paratesticular tumours are rare. We report a case of paratesticular malignant mesothelioma in a patient who had excision of an adenomatoid tumour on the same site in 2 occasions previously. PRESENTATION OF CASEA middle aged man who had an adenomatoid tumour excised from his left hemiscrotum fifteen years previously was referred with a suspicious left epididymal lump. This was followed up sonographically for 2 years until it showed signs of enlargement and testicular invasion; it was then managed with radical orchidectomy. The histology showed paratesticular epithelioid malignant mesothelioma. The patient was referred to the Oncologists for further management. DISCUSSIONParatesticular tumours are commonly benign. Scrotal ultrasonography is the preferred diagnostic imaging method. Paratesticular malignant mesotheliomas are very rare and appear to have poor prognosis. The optimal adjuvant treatment post radical orchidectomy is not established yet. In our case there is suggestion of possible malignant transformation from previous adenomatoid tumour. CONCLUSIONIn recurrent paratesticular tumours the clinicians should question the possibility of malignant transformation and manage these cases accordingly.