Metastasis Of Malignant Pleural Mesothelioma Research Articles

The Epithelial-to-Mesenchymal Transition (EMT) in the Development and Metastasis of Malignant Pleural Mesothelioma.

Malignant pleural mesothelioma (MPM) is an aggressive tumor mainly associated with asbestos exposure and is characterized by a very difficult pharmacological approach. One of the molecular mechanisms associated with cancer onset and invasiveness is the epithelial-to-mesenchymal transition (EMT), an event induced by different types of inducers, such as transforming growth factor β (TGFβ), the main inducer of EMT, and oxidative stress. MPM development and metastasis have been correlated to EMT; On one hand, EMT mediates the effects exerted by asbestos fibers in the mesothelium, particularly via increased oxidative stress and TGFβ levels evoked by asbestos exposure, thus promoting a malignant phenotype, and on the other hand, MPM acquires invasiveness via the EMT event, as shown by an upregulation of mesenchymal markers or, although indirectly, some miRNAs or non-coding RNAs, all demonstrated to be involved in cancer onset and metastasis. This review aims to better describe how EMT is involved in driving the development and invasiveness of MPM, in an attempt to open new scenarios that are useful in the identification of predictive markers and to improve the pharmacological approach against this aggressive cancer.

Cellular cannibalism and consequent thrombocytopenia in a patient with bone marrow metastasis of malignant pleural mesothelioma: A case report.

Cellular cannibalism is a tumor activity where a cell is engulfed by another cell. This process promotes tumor cell survival under unfavorable conditions. The current report describes an extremely rare case of thrombocytopenia resulting from cellular cannibalism in a patient with bone marrow metastasis due to malignant pleural mesothelioma (MPM). A 77-year-old male presented with hemothorax and thrombocytopenia. He was diagnosed with MPM of the sarcomatoid cell type. However, his disease progressed rapidly and he died 11 days after admission. Bone marrow aspiration revealed metastatic MPM cells that had engulfed other blood cells. Accordingly, the observed thrombocytopenia was attributed to cellular cannibalism by metastatic MPM tumor cells. To the best of our knowledge, this is the first reported case of thrombocytopenia due to cellular cannibalism in a patient with this type of malignancy (MPM). The results suggested that although MPM rarely metastasizes to the bone marrow, bone marrow aspiration could be useful in such cases.

Metastasis of malignant pleural mesothelioma to the scalp following chemotherapy: A case report and review of the literature

Malignant pleural mesothelioma is a neoplasm involving mesothelial cells of the pleura. Both local and distant metastases may develop, although the latter are less common and it is extremely rare for cutaneous metastases to appear as a solitary lesion on the scalp. We present the case of a 54-year-old woman with a 2-year history of unresectable left pleural mesothelioma treated with chemotherapy, who had developed a painful lump on the scalp one month prior to consultation. Skin metastases of mesothelioma must be differentiated from primary neoplasms, and immunohistochemistry is fundamental to determine the origin of such lesions, which can be correctly identified through the use of a panel of markers.

Brain Metastasis in Malignant Pleural Mesothelioma Presenting as Intratumoral Hemorrhage -Case Report-

A 51-year-old man presented with a rare case of brain metastasis of malignant pleural mesothelioma (MPM) manifesting as intratumoral hemorrhage. He had undergone several treatments such as left pneumonectomy, pleurectomy, chemotherapy with cis-diamminedichloroplatinum and gemcitabine hydrochloride, and irradiation. Five years later, computed tomography revealed right parietal metastasis with intratumoral hemorrhage and the patient was treated by surgery and irradiation. Six months after the surgery, recurrent intratumoral hemorrhage occurred and a second surgery was performed. MPM has a poor prognosis and brain metastasis is rare, but long-term survival has recently improved through the application of multi-modality approaches. Therefore, the number of opportunities for treating MPM metastasis will increase in the near future. Intratumoral hemorrhage may occur in patients with solitary brain metastasis of MPM, so surgery should be considered as a general candidate treatment for metastatic tumors.

Diagnosis of small-bowel metastasis of malignant pleural mesothelioma by capsule endoscopy and double ballon enteroscopy

A 62-year-old man who was diagnosed with malignant pleural mesothelioma ([Fig. 1]) underwent right extrapleural pneumonectomy. He was followed up with chest radiographs, computed tomographic scans, and laboratory investigations, none of which showed any findings. Nine months later, he was readmitted for the investigation of tarry stools and iron deficiency anemia. Esophagogastroduodenoscopy, total colonoscopy, red blood cell scintigraphy, and computed tomography did not identify any cause for the gastrointestinal bleeding. Video capsule endoscopy, however, revealed multiple protruding lesions with slight but continuous oozing throughout the entire small intestine ([Fig. 2 a]); and double-balloon enteroscopy identified protrusions that were covered with normal mucosa with central ulceration and mild bleeding ([Fig. 2 b]). Examination of biopsy specimens showed these protusions to contain tumor cells which ranged in appearance from large polyhedral cells to spindle-shaped cells ([Fig. 3 a]). Immunohistochemical examination revealed tumor cells positive for the mesothelial markers, calretinin and WT1 ([Fig. 3 b]), and the protrusions were diagnosed as metastatic malignant mesothelioma of the small bowel.

Solitary cerebellar metastasis of malignant pleural mesothelioma: case report

Background Malignant pleural mesothelioma is an uncommon malignancy that rarely metastasizes to the central nervous system and even less frequently occurs as a solitary lesion. Case description We present a 71-year-old white female, nonsmoker, with no occupational exposure to asbestos. She presented with a 15-lb. weight loss over several months and persistent right subscapular pain radiating to her anterior chest. Imaging studies revealed a pleural mass, and biopsy confirmed fibrous type malignant pleural mesothelioma. During a metastatic workup, computed tomography (CT) and magnetic resonance imaging (MRI) of the head demonstrated a 1 cm subcortical, contrast-enhancing lesion without surrounding edema in the right posterior cerebellum. Surgical resection of the solitary cerebellar mass revealed fibrous-type metastatic malignant mesothelioma. Postoperatively, the patient received a combined chemotherapy regimen of Adriamycin and Cisplatin and underwent whole brain radiation therapy. Conclusions We report the first resection of a solitary cerebellar metastasis of malignant pleural mesothelioma. We also review past cases of intracranial metastasis of this malignancy, its histologic subtypes, outcome, and recent treatment modalities.