833 results on '"Mesothelioma complications"'
Search Results
2. Venous Thromboembolism in Peritoneal Mesothelioma: Uncovering the Hidden Risk.
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Bansal VV, Mitchell O, Bregio C, Witmer HDD, Dhiman A, Godley FA 4th, Ong C, Berger Y, Reddy B, Churpek JE, Drazer MW, Eng OS, Kindler HL, and Turaga KK
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- Humans, Anticoagulants therapeutic use, Retrospective Studies, Risk Factors, Postoperative Complications etiology, Postoperative Complications prevention & control, Venous Thromboembolism etiology, Venous Thromboembolism prevention & control, Pulmonary Embolism etiology, Mesothelioma, Malignant, Mesothelioma complications
- Abstract
Introduction: Venous thromboembolism (VTE) is a common complication in patients with abdominal malignancies. Despite known associations between pleural mesothelioma and increased VTE risk, the characteristics of VTE in patients with peritoneal mesothelioma (PeM) remain undescribed., Methods: Patients treated for PeM were retrospectively identified from our institutional database. The frequency of VTE was assessed and logistic regression modeling was employed to assess VTE risk factors. The association between VTE and overall survival was also ascertained. Recommended thromboprophylaxis for patients who underwent surgery at our institution comprised a single preoperative dose of prophylactic anticoagulation, followed by daily dosing for four weeks postoperatively., Results: Among 120 PeM patients, 26 (21.7%) experienced VTE, including 19/91 (20.9%) surgical patients, 4/23 (17.4%) patients who received systemic therapy, and 3/6 (50%) patients who underwent observation (p = 0.21). Most events were symptomatic (n = 16, 62%) and were attributable to pulmonary emboli (n = 16, 62%). The 90-day postoperative VTE rate was 4.4% (4/91), including 1 of 60 patients who underwent index surgical intervention at our institution and 3 patients with surgery elsewhere. A low serum albumin concentration was associated with VTE in non-surgical patients (odds ratio 0.12, confidence interval [CI] 0.02-0.72; p = 0.03). No significant difference in overall survival was observed between patients with and without VTE (median 46.0 months [CI 24.9-67.0] vs. 55.0 months [CI 27.5-82.5]; hazard ratio 0.98 [CI 0.54-1.81], p = 0.98)., Conclusions: A high risk of VTE was observed in PeM patients, warranting suspicion throughout the disease trajectory. Postoperative VTE rates were within acceptable limits with 4-week thromboprophylaxis., (© 2024. Society of Surgical Oncology.)
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- 2024
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3. The diagnosis of asbestosis in the 21 st century: a clinicopathological correlation of 102 cases.
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Carney JM, Sporn TA, Roggli VL, and Pavlisko EN
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- Male, Humans, Female, Middle Aged, Aged, Aged, 80 and over, Lung pathology, Asbestos, Amosite, Asbestosis pathology, Asbestos, Mesothelioma complications, Mesothelioma pathology, Lung Neoplasms pathology, Mesothelioma, Malignant, Occupational Exposure
- Abstract
Asbestosis, defined as diffuse pulmonary fibrosis caused by inhalation of asbestos fibers, occurs after heavy exposures to asbestos dust over several decades. Because workplace exposures have been significantly curtailed since the banning of asbestos in insulation products, we were interested in examining the clinicopathological characteristics of cases diagnosed in the 21
st century. The consultation files of one of the authors (VLR) were reviewed for cases of asbestosis diagnosed since 1/1/2001. 102 cases were identified, with a median age of 75 years (range: 45-89). There were 100 men and 2 women. The women were from Turkey and Brazil (none from the United States). Malignancies were present in 78 cases, including 38 lung cancers, 29 pleural mesotheliomas, and 8 peritoneal mesotheliomas. The grade of asbestosis was available in 88 cases (median severity of 2; scale: 1-4). Pleural plaque was present in 94% of cases. The most common exposure categories were insulators (39), shipyard workers (16), asbestos manufacturing (9), boiler workers (8) and pipefitter/welders (6). The median duration of exposure was 33 years (range: 2-49 years). Lung fiber burden analysis was performed in 34 cases, with amosite being the predominant fiber type. Results were compared with similar information for 475 cases diagnosed prior to 1/1/2001.- Published
- 2024
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4. Malignant Peritoneal Mesothelioma Complicating Familial Mediterranean Fever on 18 F-FDG PET/CT.
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Fayand A, Kerrou K, Wendum D, Grateau G, and Georgin-Lavialle S
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- Male, Humans, Aged, Positron Emission Tomography Computed Tomography, Fluorodeoxyglucose F18, Familial Mediterranean Fever complications, Familial Mediterranean Fever diagnostic imaging, Familial Mediterranean Fever drug therapy, Mesothelioma complications, Mesothelioma diagnostic imaging, Mesothelioma, Malignant complications, Peritoneal Neoplasms complications, Peritoneal Neoplasms diagnostic imaging, Peritoneal Neoplasms pathology
- Abstract
Abstract: A 77-year-old man with a personal history of familial Mediterranean fever presented with a slowly enlarging tumefaction of the left abdominal wall and persistent inflammatory syndrome despite good adherence to colchicine. 18 F-FDG PET/CT showed a hypermetabolic muscular mass of the abdominal wall along with other hypermetabolic lesions including a peritoneal mass and several subcutaneous soft tissue nodules. CT-guided needle biopsy led to the diagnosis of a muscular localization of a malignant peritoneal mesothelioma, which is an extremely rare complication of familial Mediterranean fever. Six courses of chemotherapy with carboplatin and pemetrexed allowed an almost complete response., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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5. A Rare Presentation of Minimally Invasive Mesothelioma as a Large Tension Pneumothorax.
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Marshall T, Lane J, and Lahorra J
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- Male, Humans, Aged, 80 and over, Pleura surgery, Pneumothorax diagnosis, Pneumothorax etiology, Pneumothorax surgery, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma surgery, Mesothelioma, Malignant complications, Pleural Effusion complications, Pleural Neoplasms complications, Pleural Neoplasms diagnosis, Pleural Neoplasms surgery
- Abstract
Development of mesothelioma is associated with asbestos exposure. Common presentations are with pleural-based plaques invading the chest wall and/or pleural effusion on chest imaging. The intent of this case report is to describe a rare presentation of mesothelioma, which presented atypically as a large tension pneumothorax. A 93-year-old male presented with a history of dyspnea that started after a coughing episode. On physical examination he was hemodynamically stable, but was hypoxic requiring 2L of supplemental oxygen. Computed tomography of the chest revealed a large right tension pneumothorax. A chest tube was placed and connected to suction (-20cmH
2 0), but he continued to have an unresolving air leak over the following 2-week period. Upon video-assisted thoracotomy there were no blebs or adhesions seen. Right apical wedge resection and talc pleurodesis were performed. Pathologic examination revealed an atypical mesothelial cell proliferation with minimal, focal invasion into the pulmonary parenchyma. Tumor spread along the visceral pleura was thought to be the underlying cause of the pneumothorax. The surgical margins were uninvolved by the tumor, and the patient was later discharged home in stable condition. This was a rare presentation of what could best be described as minimally invasive mesothelioma arising in a background of probable mesothelioma in situ, which presented atypically as a large tension pneumothorax. This case highlighted the importance of establishing a pathologic diagnosis from pleural effusion cytology and/or pleural biopsy in persons presenting with spontaneous pneumothorax, and the difficulty in confirming a pathologic diagnosis of early mesothelial neoplasia., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.- Published
- 2024
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6. Psychosocial well-being among patients with malignant pleural mesothelioma.
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Demirjian CC, Saracino RM, Napolitano S, Schofield E, Walsh LE, Key RG, and Holland J
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- Humans, Male, Adult, Middle Aged, Aged, Aged, 80 and over, Quality of Life psychology, Mesothelioma, Malignant, Pleural Neoplasms complications, Pleural Neoplasms diagnosis, Pleural Neoplasms pathology, Lung Neoplasms complications, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma pathology
- Abstract
Objectives: The investigators conducted a psychosocial needs assessment of mesothelioma patients through self-report measures of quality of life (QOL), coping, depression, and social support., Methods: Patients with malignant pleural mesothelioma (MPM) ( N = 67) completed a battery of assessments at a single timepoint after being approached during routine medical oncology clinic appointments or by letter., Results: Participants were predominately male (70.0%; n = 47) and ranged in age from 35 to 83 years old ( M = 65.61, SD = 9.71). Most participants were white (88.0%; n = 59), and 10.0% ( n = 7) were identified as Hispanic. The majority were married or living with a partner (93.0%; n = 62) and had some college or more education (64.0%; n = 43). Fourteen percent of participants ( n = 11) endorsed significantly elevated depression symptoms. No significant demographic or clinical differences in depressed compared to nondepressed participants were observed, with a trend toward those identifying as Hispanic and those who were divorced as being more likely to be depressed. For the total sample, the most frequently endorsed coping strategies were active coping, emotional support, and acceptance., Significance of Results: The present study did not identify any clear correlates of depression or QOL among patients with MPM. This research contributes to the small literature on psychosocial functioning in patients with MPM and provides putative directions for future larger studies and the development of interventions to provide appropriate support to diverse patients with MPM.
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- 2024
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7. Intrapleural injection of brucea javanica oil emulsion provided a long-term benefits in patient with malignant pleural effusion from pleural mesothelioma: A case report.
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Zhou H, Wang Q, Jiao L, Bi L, Sang S, Han Y, Gan S, Liu R, A G, and Gong Y
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- Humans, Brucea javanica, Emulsions therapeutic use, Plant Oils therapeutic use, Brucea, Mesothelioma complications, Mesothelioma drug therapy, Mesothelioma, Malignant, Pleural Effusion, Malignant drug therapy, Pleural Effusion, Malignant pathology
- Abstract
Malignant pleural mesothelioma (MPM) is a severe form of cancer that originates from mesothelium cells. Around 54-90% of mesotheliomas are associated with pleural effusions. Brucea Javanica Oil Emulsion (BJOE) is the processed oil derived from the seeds of Brucea javanica, which has shown potential as a treatment option for several types of cancer. Here, we present a case study of a MPM patient with malignant pleural effusion who received intrapleural injection of BJOE. The treatment resulted in the complete response of pleural effusion and chest tightness. While the precise mechanisms underlying the therapeutic effects of BJOE for pleural effusion are not yet fully understood, it has demonstrated a satisfactory clinical response without significant adverse effects., (Copyright © 2023. Published by Elsevier Inc.)
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- 2024
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8. Percutaneous cervical cordotomy for chest wall pain from mesothelioma in the setting of neuromyelitis.
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McMorrow F and Owen M
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- Male, Humans, Aged, Cordotomy, Neoplasm Recurrence, Local, Pain complications, Mesothelioma, Malignant complications, Mesothelioma, Malignant surgery, Thoracic Wall surgery, Mesothelioma complications, Mesothelioma surgery
- Abstract
A 75-year-old man presented to our Interventional Cancer Pain service for consideration of a percutaneous cervical cordotomy (PCC) to control severe chest wall pain secondary to malignant mesothelioma. His medical history included a neuroinflammatory disorder, neuromyelitis optica, for which he had previously had a prolonged hospital admission, with ongoing neurological deficit. Little information is available regarding the safety of PCC in a patient with this condition, specifically the risk of neurological relapse, and we were initially wary about going ahead. After discussion with the patient's neurology team and other UK experts and with the patient's informed consent, we proceeded to PCC with additional steroid cover. No adverse neurological symptoms were encountered perioperatively or postoperatively and the patient had an excellent analgesic result. As this combination of circumstances has not to our knowledge been documented, we wished to present this case and discuss the factors affecting our decision and management., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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9. Clinically Occult Diffuse Pleural Mesothelioma in Patients Presenting With Spontaneous Pneumothorax.
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Fels Elliott DR, Konopka KE, Hrycaj SM, Lagisetty KH, Myers JL, Farver CF, and Huang T
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- Male, Humans, Aged, Retrospective Studies, Pneumothorax diagnosis, Pneumothorax surgery, Mesothelioma, Malignant, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma surgery, Pleural Neoplasms complications, Pleural Neoplasms diagnosis
- Abstract
Objectives: To report histologic features of unsuspected diffuse pleural mesothelioma (DPM) in surgical specimens for pneumothorax and demonstrate how ancillary markers support a diagnosis of malignancy in this context. We explored whether pneumothorax may be a clinical manifestation of mesothelioma in situ (MIS)., Methods: A single-institution database search identified patients who underwent surgical resection for spontaneous pneumothorax (n = 229) and/or were diagnosed with DPM (n = 88) from 2000 to 2020., Results: Spontaneous pneumothorax without clinical, radiologic, or intraoperative suspicion of mesothelioma was the initial presentation in 2 (2.3%) of 88 patients diagnosed with DPM. This represented 0.9% (2/229) of all patients undergoing surgical management of pneumothorax but accounted for a larger proportion of older patients (12.5% older than 70 years). Immunohistochemistry for BAP-1 and/or MTAP confirmed the diagnosis of DPM in 2 cases. Mesothelioma in situ was identified retrospectively by immunohistochemistry in 1 case of spontaneous pneumothorax from a 77-year-old man who developed invasive DPM 25 months later. No additional cases of MIS were identified in 19 surgical lung resections for spontaneous pneumothorax., Conclusions: Histologic examination of bleb resections with ancillary testing for cases with ambiguous features is essential for detection of early DPM. It is uncertain whether spontaneous pneumothorax may represent a clinical manifestation of MIS., (© The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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10. Metachronous double primary malignant tumors with nasopharyngeal carcinoma and diffuse malignant peritoneal mesothelioma accompanied with paraneoplastic syndromes treated with nivolumab: A case report.
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Tang LK, Li ZK, Xiang YL, Ma DY, and Du GB
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- Male, Humans, Middle Aged, Peritoneum pathology, Nivolumab therapeutic use, Nasopharyngeal Carcinoma, Mesothelioma complications, Mesothelioma drug therapy, Mesothelioma, Malignant, Peritoneal Neoplasms therapy, Peritoneal Neoplasms drug therapy, Paraneoplastic Syndromes etiology, Nasopharyngeal Neoplasms complications, Nasopharyngeal Neoplasms drug therapy
- Abstract
Rationale: Multiple primary malignant tumors are rare and challenging to diagnose. Diffuse malignant peritoneal mesothelioma (DMPM) originate from the peritoneum, which lacks specific clinical manifestations and is difficult to diagnose, with a short survival about 10 to 13 months for inoperable ones. This is the first report of metachronous double primary malignant tumors in nasopharyngeal carcinoma and DMPM accompanied with paraneoplastic syndromes., Patient Concerns: A 61-year-old man presented with abdominal discomfort with a history of nasopharyngeal carcinoma 5 years ago., Diagnoses: The diagnosis of DMPM was finally confirmed by laparoscopic mesenteric biopsies. Paraneoplastic syndromes including increased platelets were present when diagnosis, followed by increased neutrophils after disease progression., Interventions: Due to intolerable for surgery, he was treated with pemetrexed combined with nivolumab, intraperitoneal infusion of nivolumab, radiotherapy, anlotinib and maintenance treatment of nivolumab., Outcomes: Progression-free survival in first line is 12 months, overall survival is 23 months., Lessons: This indicate that comprehensive treatment including immunotherapy may be helpful for inoperable DMPM patients with nasopharyngeal carcinoma accompanied with paraneoplastic syndromes., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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11. Current causes of mesothelioma: how has the asbestos ban changed the perspective?
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Janosikova M, Nakladalova M, and Stepanek L
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- Humans, Female, Adolescent, Environmental Exposure adverse effects, Minerals, Nanotubes, Carbon, Lung Neoplasms chemically induced, Mesothelioma chemically induced, Mesothelioma complications, Mesothelioma, Malignant chemically induced, Mesothelioma, Malignant complications, Asbestos adverse effects, Pleural Neoplasms chemically induced, Pleural Neoplasms complications
- Abstract
The association of mesothelioma, a lethal lung disease, with asbestos has led to an absolute ban on asbestos in at least 55 countries worldwide. The purpose of this paper is to review residual exposure to asbestos as well as other emerging causes of mesothelioma outside asbestos. The review provides detailed description of asbestos minerals, their geographical locations, mesothelioma in these areas, as well as contemporary possible sources of asbestos exposure. Second, we examine other emerging causes of mesothelioma including: ionizing radiation as the second most important risk factor after asbestos, particularly relevant to patients undergoing radiotherapy, third, carbon nanotubes which are under investigation and fourth, Simian virus 40. In the case of asbestos per se, the greatest risk is from occupational exposure during mining and subsequent processing. Of the non-occupational exposures, environmental exposure is most serious, followed by exposure from indoor asbestos minerals and secondary familial exposure. Overall, asbestos is still a major risk factor, but alternative causes should not be neglected, especially in young people, in women and those with a history of radiotherapy or living in high-risk locations., Competing Interests: The authors report no conflicts of interest in this work.
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- 2023
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12. A Narrative Review-Management of Malignant Pleural Effusion Related to Malignant Pleural Mesothelioma.
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Qureshi M, Thapa B, and Muruganandan S
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- Humans, Mesothelioma, Malignant, Pleural Effusion, Malignant etiology, Pleural Effusion, Malignant therapy, Mesothelioma complications, Mesothelioma therapy, Mesothelioma diagnosis, Pleural Neoplasms complications, Pleural Neoplasms therapy, Pleural Neoplasms diagnosis, Pleural Effusion pathology, Lung Neoplasms complications, Lung Neoplasms therapy, Lung Neoplasms diagnosis
- Abstract
Malignant pleural mesothelioma (MPM) is an aggressive, almost universally fatal cancer with limited therapeutic options. Despite efforts, a real breakthrough in treatment and outcomes has been elusive. Pleural effusion with significant breathlessness and pain is the most typical presentation of individuals with MPM. Although thoracentesis provides relief of breathlessness, most such pleural effusions recur rapidly, and a definitive procedure is often required to prevent a recurrence. Unfortunately, the optimal treatment modality for individuals with recurrent MPM-related effusion is unclear, and considerable variation exists in practice. In addition, non-expandable lung is common in pleural effusions due to MPM and makes effective palliation of symptoms more difficult. This review delves into the latest advances in the available management options (both surgical and non-surgical) for dealing with pleural effusion and non-expandable lung related to MPM. We discuss factors that determine the choice of definitive procedures that need to be tailored to the individual patient., (Copyright © 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
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- 2023
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13. Haematochezia: an atypical presentation of metastatic malignant pleural mesothelioma.
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Peacock T, Klebe S, Barnard J, and Mor I
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- Humans, Pleura pathology, Mesothelioma, Malignant, Mesothelioma complications, Lung Neoplasms complications
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- 2023
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14. Primary pericardial mesothelioma complicated by pericardial calcification.
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Zhang J, Liu D, Zhang D, Guo K, and Yang X
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- Female, Humans, Middle Aged, Diagnosis, Differential, Pericardium diagnostic imaging, Pericardium surgery, Pericardium pathology, Mesothelioma complications, Mesothelioma diagnostic imaging, Mesothelioma therapy, Pericarditis, Constrictive diagnostic imaging, Pericarditis, Constrictive etiology, Pericarditis, Constrictive surgery, Mesothelioma, Malignant complications, Heart Neoplasms complications, Heart Neoplasms diagnostic imaging, Heart Neoplasms surgery, Heart Failure diagnosis, Thymus Neoplasms complications
- Abstract
Background: Pericardial calcification is usually a marker of chronic diseases, and its occurrence in rapidly progressing malignant primary pericardial mesothelioma (PPM) is extremely rare. Therefore, this atypical imaging appearance contributes to more frequent misdiagnosis of PPM. However, no systematic summary currently exists of the imaging characteristics of malignant pericardial calcification in PPM. In our report, its clinical characteristics are discussed in detail, to provide a reference to reduce the misdiagnosis rates of PPM., Case Presentation: A 50-year-old female patient was admitted to our hospital, presenting primarily with features suggestive of cardiac insufficiency. Chest computed tomography revealed significant pericardial thickening and localized calcification, suspicious of constrictive pericarditis. A chest examination performed through a midline incision showed a chronically inflamed and easily-ruptured pericardium that was closely adherent to the myocardium. Post-operative pathological examination confirmed a diagnosis of primary pericardial mesothelioma. Six weeks postoperatively, the patient experienced symptom recurrence and abandoned chemotherapy and radiation therapy. Nine months postoperatively, the patient died of heart failure., Conclusion: We report this case to highlight the rare finding of pericardial calcification in patients with primary pericardial mesothelioma. This case illustrated that confirmation of pericardial calcification cannot completely rule out rapidly developing PPM. Therefore, understanding the different radiological features of PPM can help to reduce its rate of early misdiagnosis., (© 2023. The Author(s).)
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- 2023
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15. A rare case of primary gastric Burkitt's lymphoma associated with malignant pleural mesothelioma.
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Spaziani E, Di Filippo AR, Valle G, Spaziani M, Francioni P, Caruso G, Tamagnini GT, Mosciatti E, Picchio M, and De Cesare A
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- Humans, Male, Aged, Dyspnea complications, Mesothelioma, Malignant complications, Burkitt Lymphoma complications, Burkitt Lymphoma diagnosis, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma pathology, Pleural Neoplasms complications, Pleural Neoplasms diagnosis, Pleural Neoplasms pathology, Pleural Effusion, Respiratory Insufficiency complications
- Abstract
Background: Primary gastric Burkitt lymphoma (PG BL) and malignant pleural mesothelioma (MPM) are rare and aggressive tumors with poor prognosis. HIV and EBV infection have a link in the aetiology of PG BL, while MPM is usually associated with asbestos exposure. Endoluminal bleeding from massive solid tumor, and dyspnea usually due to pleural effusion, are the typical clinical manifestations respectively of PG BL and MPM. In most patients just palliative treatment is indicated., Case Report: A caucasian elderly male, negative for the proven risk factors, presenting respiratory failure due to massive left pleural effusion with severe mediastinal shift. Contrast enhanced - Computed Tomography (CE-CT) showed a large mass causing circumferential thickening of the gastric fundus, infiltrating the left diaphragmatic dome and the ipsilateral crus. Macroscopically, on endoscopy the gastric fundus appeared completely occupied by an ulcerated large mass protunding in the gastric lumen. Histopathological examination from biopsy specimens taken during esophagogastroduodenoscopy and thoracoscopy allowed to make diagnosis of PG BL and MPM. The patient first underwent a placement of a chest tube drainage for the pleural effusion and then a thoracoscopic talc insufflation (TTI) in the left hemithorax. A surgical treatment of the gastric lesion was planned, due to the rapid growth and the high risk of bleeding. The patient died because of fatal cardiac arrhythmia, before undergoig abdominal surgery., Conclusions: This report presents an unique case of PG BL associated with MPM and highlights the real challenge for the physicians to identify them in early stage, especially in patients without the proved risk factors. The onset symptoms make it a very singular case, characterized by severe dyspnea up to respiratory failure, due to massive left pleural effusion and contralateral mediastinal fluttering, without an active bleeding from the gastric mass, while CE-CT findings were instead negative for pleural thickening and positive for circumferential thickening of the gastric fundus., Key Words: Burkitt Lymphoma, Case Report, Gastric, Pleural Mesothelioma, Pleural Effusion, Respiratory Failure.
- Published
- 2023
16. Coronary Artery Stenosis Caused by Primary Malignant Pericardial Mesothelioma in a 76-Year-Old Man.
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Machii Y, Sezai A, Taoka M, Osaka S, Suzuki K, Onuki Y, and Tanaka M
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- Male, Humans, Aged, Minimally Invasive Surgical Procedures methods, Echocardiography, Coronary Stenosis diagnostic imaging, Coronary Stenosis etiology, Heart Neoplasms complications, Heart Neoplasms diagnosis, Heart Neoplasms surgery, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma surgery
- Abstract
This report describes a 76-year-old man with diabetes mellitus who developed coronary artery stenosis from infiltration of a primary malignant pericardial mesothelioma. Three months before referral to the treating hospital, elevated liver function values and cardiac enzymes led to echocardiography, which revealed a motion abnormality in the anterior wall of the heart. The patient was diagnosed with congestive heart failure and admitted to the hospital, where chest computed tomography showed a tumor above the left atrial appendage that compressed the origin of the left anterior descending artery. He was referred to the treating hospital for surgery. Minimally invasive direct coronary artery bypass grafting was performed, but the mass was not resected because of its infiltrating nature and the potential for medical complications. Histologic examination of a biopsy specimen confirmed a primary malignant pericardial mesothelioma. The bypass procedure resolved the coronary artery stenosis caused by the tumor. Although the optimal treatment for primary malignant pericardial mesothelioma is controversial, minimally invasive methods, such as minimally invasive direct coronary artery bypass grafting, may be used successfully., (© 2022 by the Texas Heart® Institute, Houston.)
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- 2022
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17. Benign multi-cystic peritoneal mesothelioma discovered at the time of acute appendicitis: a rare pathology in association with a common disease.
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McGahan W, Lah K, Iyengar K, and Naidu S
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- Humans, Peritoneum pathology, Appendicitis complications, Appendicitis diagnosis, Appendicitis surgery, Mesothelioma, Cystic complications, Mesothelioma, Cystic diagnosis, Mesothelioma, Cystic surgery, Peritoneal Neoplasms pathology, Mesothelioma complications, Mesothelioma diagnosis
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- 2022
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18. Spontaneous urinary bladder perforation: An unusual presentation of well-differentiated papillary peritoneum mesothelioma.
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Serao A, Ambrosini F, Cavallone B, Borra T, and Di Stasio A
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- Aged, Humans, Male, Peritoneum pathology, Urinary Bladder pathology, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma surgery, Peritoneal Neoplasms complications, Peritoneal Neoplasms diagnosis, Peritoneal Neoplasms surgery, Urinary Bladder Diseases
- Abstract
Introduction: Well-differentiated papillary mesothelioma (WDPM) is a very rare neoplasm. Most of WDPM are asymptomatic and are often incidentally detected during surgery. This report describes a case of WDPM of the peritoneum unexpectedly diagnosed in a male with a spontaneous intraperitoneal bladder rupture., Case Presentation: A 65-year-old male presented to our Emergency Department in November 2019 with a two-day history of anuria, abdominal pain, distention, and sepsis. The CT scan reported a large amount of extra and intraperitoneal free fluid. The CT cystogram showed bladder perforations on the dome and on the left lateral wall which was repaired through exploratory laparotomy. Intraoperatively, we encountered extensive suppurative peritonitis with large fibrino-purulent exudation. The purulent perivesical peritoneum was dissected and sent for histopathological examination which unexpectedly resulted in WDPM of the peritoneum., Conclusion: Although we can't affirm with certainty, this case would seem to suggest that WDPM had played a role in patient's clinical presentation. However, further research is necessary to draw stronger conclusion.
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- 2022
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19. Progression of Peritoneal Mesothelioma In Situ to Invasive Mesothelioma Arising in the Setting of Endometriosis With Germline BAP1 Mutation: A Case Report.
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Fels Elliott DR, Travieso JL, As-Sanie S, Hrycaj SM, Lieberman RW, Myers JL, and Huang T
- Subjects
- Biomarkers, Tumor genetics, Female, Germ Cells pathology, Germ-Line Mutation, Humans, Retrospective Studies, Tumor Suppressor Proteins genetics, Ubiquitin Thiolesterase genetics, Endometriosis complications, Endometriosis genetics, Endometriosis surgery, Lung Neoplasms diagnosis, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma genetics, Mesothelioma, Malignant, Peritoneal Neoplasms genetics, Peritoneal Neoplasms pathology
- Abstract
Mesothelioma in situ has been proposed as a precursor to malignant mesothelioma arising in the pleura or peritoneum. We report a case of malignant peritoneal mesothelioma which progressed from mesothelioma in situ over a 10-mo period in a 24-yr-old woman with stage IV endometriosis. Initial surgery showed deeply infiltrative endometriosis with progestin effect. Postoperatively the patient had intractable pelvic pain and vaginal discharge. Imaging studies were negative. Repeat laparoscopy 10 mo later revealed vesicular lesions on the omentum and pinpoint white lesions studding the small bowel, appendix, and pelvic peritoneum. A diagnosis of epithelioid mesothelioma was established on biopsy of the omentum and confirmed by immunohistochemistry showing complete loss of BRCA1-associated protein-1 (BAP1) nuclear staining. Retrospectively, BAP1 loss was identified in the cytologically bland, single-layer surface mesothelium of the prior resection specimen, consistent with mesothelioma in situ . The patient underwent genetic testing and was found to have a pathogenic germline mutation in BAP1 ., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 by the International Society of Gynecological Pathologists.)
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- 2022
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20. Pulmonary Asbestos Fiber Burden Is Related to Patient Survival in Malignant Pleural Mesothelioma.
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Laaksonen S, Kettunen E, Sutinen E, Ilonen I, Vehmas T, Törmäkangas T, Räsänen J, Wolff H, and Myllärniemi M
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- Humans, Lung pathology, Retrospective Studies, Asbestos adverse effects, Lung Neoplasms pathology, Mesothelioma complications, Mesothelioma, Malignant, Occupational Exposure adverse effects, Pleural Neoplasms pathology
- Abstract
Introduction: Malignant pleural mesothelioma (MPM) is associated with poor prognosis and is strongly associated with occupational asbestos exposure. Given the importance of asbestos exposure in MPM pathogenesis, we retrospectively analyzed the types and concentrations of asbestos fibers within the lung tissues of patients with MPM and investigated their effects on all-cause mortality., Methods: We formed a national data set of patients with MPM identified from the Finnish Cancer Registry and Statistics Finland. These data were merged with pulmonary asbestos fiber analysis results received from the Finnish Institute of Occupational Health., Results: We identified 590 patients with MPM who underwent pulmonary asbestos fiber analysis. The median asbestos concentration within dry lung tissue was 3.20 million fibers/gram (range: 0 - 1700 million fibers/gram). Crocidolite and anthophyllite were the most prevalent asbestos fiber types detected in lung tissue. The multivariable risk of death analyses, where changes over time were accounted for, revealed that total asbestos fiber concentration was associated with increased mortality. Nevertheless, no difference in mortality was noted between different fiber types., Conclusions: Our study revealed that pulmonary fiber concentrations correlated with the manner of asbestos usage. Anthophyllite was identified as the sole fiber in a sizable proportion of cases, supporting its independent role in the pathogenesis of MPM. Our findings suggest that asbestos fiber burden, but not fiber type, may have an impact on the prognosis of MPM., (Copyright © 2022 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
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- 2022
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21. Extensive intrathoracic and intraperitoneal splenosis mimicking mesothelioma: a case report.
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Föh B, Sieren MM, Both M, Seeger M, and Günther R
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- Diagnosis, Differential, Humans, Male, Middle Aged, Splenectomy, Abdominal Injuries complications, Mesothelioma complications, Mesothelioma diagnostic imaging, Splenosis diagnostic imaging, Splenosis etiology, Wounds, Gunshot complications
- Abstract
Background: Splenosis is the heterotopic autotransplantation of splenic tissue after severe splenic trauma and/or splenectomy. The epidemiology is elusive, but splenosis is frequently misdiagnosed as malignant tumors of gastrointestinal, gynecological, or hematological origin before the correct diagnosis is ultimately found. We herein report a rare case of combined, extensive intraabdominal and intrathoracic splenosis initially presenting as pleural mesothelioma., Case Presentation: A 63-year-old Caucasian male presented with dyspnea and recurring thoracic pain. Initial X-ray and computed tomography scans showed disseminated intrathoracic and intraabdominal lesions. Consequently, thoracoabdominal mesothelioma or a polytopically metastasized cancer of unknown origin was suspected. A thorough examination of the patient's medical history and contrast-enhanced ultrasound by a skilled examiner revealed the diagnosis of extensive abdominal and thoracic splenosis as a consequence of an abdominal gunshot wound with a ruptured diaphragm several decades earlier. Timely diagnosis by noninvasive measures prevented the patient from potential complications of harmful diagnostic procedures, including nuclear imaging and biopsies. The patient is currently treated for hepatitis C and chronic obstructive lung disease, whereas no specific treatment for splenosis is required., Conclusions: We present a case of rare intrathoracic and intraperitoneal splenosis mimicking mesothelioma. Contrast-enhanced ultrasound and thorough patient history were used for diagnosis and prevented this patient from having to undergo potentially harmful diagnostics. Splenosis can occur after splenic trauma and, consequently, needs to be considered as a rare differential diagnosis to malignant tumors of various origins when a matching patient history is obtained., (© 2022. The Author(s).)
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- 2022
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22. Cytological Diagnostic Procedures in Malignant Mesothelioma.
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Biancosino C, van der Linde LIS, Sauter G, Stellmacher F, Krüger M, and Welker L
- Subjects
- Aged, Female, Humans, Male, Reproducibility of Results, Sensitivity and Specificity, Adenocarcinoma pathology, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma pathology, Mesothelioma, Malignant, Pleural Effusion, Malignant diagnosis, Pleural Effusion, Malignant etiology, Pleural Effusion, Malignant pathology
- Abstract
Malignant mesotheliomas (MM) are rare tumors with high mortality rates, whose incidence varies regionally and nationally, and the diagnosis is difficult. Histology-based diagnosis is considered the gold standard despite its low sensitivity of 57-84%. However, recent advances in cytological analysis offer promise for diagnostic advancements. In this study, we reappraised the current cytological guidelines for the MM diagnosis and concluded on their practicability and reliability. The study included 5731 consecutive specimens of pleural effusions from 4552 patients (3026 males of the average age of 67.5 years and 1526 females of the average age of 65.4 years) between December 2017 and January 2000. Out of these patients, 444 (9.8%) were diagnosed with MM. The effusions were examined by immunocytochemistry using routine Giemsa staining. Additionally, hyaluronic acid (HA) was assessed. Cytological findings confirmed 223 out of the 444 MM. The additional 88 cases with negative cytology were corroborated by supplemental assessments of HA above 30 mg/L. Cytological evaluation accomplished the sensitivity of 0.50, specificity of 0.99, and a positive predictive value (PPV) of 0.97 for MM diagnosis. The use of HA determination raised the sensitivity to 0.70 without affecting the specificity or PPV. We conclude that cytological evaluation of effusions aided by the assessment of HA demonstrates the diagnostic sensitivity and specificity for MM no less than the hitherto standard histological evaluation. The cytology-based MM diagnosis may thus be routinely considered when MM is suspected and may offer confirmatory advantages in difficult or doubtful diagnostic cases., (© 2021. The Author(s), under exclusive license to Springer Nature Switzerland AG.)
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- 2022
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23. Asbestos exposure and mesothelioma mortality among atomic veterans.
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Till JE, Beck HL, Boice JD Jr, Mohler HJ, Mumma MT, Aanenson JW, and Grogan HA
- Subjects
- Cohort Studies, Humans, Male, Asbestos adverse effects, Lung Neoplasms etiology, Mesothelioma complications, Occupational Diseases etiology, Occupational Exposure adverse effects, Veterans
- Abstract
Background: The United States (U.S.) conducted 230 above-ground atmospheric nuclear weapons tests between 1945 and 1962 involving over 250,000 military personnel. This is the first quantitative assessment of asbestos-related mesothelioma, including cancers of the pleura and peritoneum, among military personnel who participated in above-ground nuclear weapons testing., Methods: Approximately 114,000 atomic veterans were selected for an epidemiological study because they were in one of eight series of weapons tests that were associated with somewhat higher personnel exposures than the other tests and because they have been previously studied. We were able to categorize specific jobs into potential for asbestos exposure based on a detailed database of the military activities of the atomic veterans. Standardized mortality ratios (SMR) were calculated by service, rank (officer/enlisted) and ratings (occupation code and work location aboard ship) after 65 years of follow-up., Results: Mesothelioma deaths were significantly increased overall (SMR 1.56; 95% CI 1.32-1.82; n = 153). This increase was seen only among those serving in the PPG (SMR 1.97; 95% CI 1.65-2.34; n = 134), enlisted men (SMR 1.81; 95% CI 1.53-2.13; n = 145), and the 70,309 navy personnel (SMR 2.15; 95% CI 1.80-2.56; n = 130). No increased mortality rates were seen among the other services: army (SMR 0.45), air force (SMR 0.85), or marines (SMR 0.75). Job categories with the highest potential for asbestos exposure (machinist's mates, boiler technicians, water tender, pipe fitters, and fireman) had an of SMR 6.47. Job categories with lower potential (SMR =1.35) or no potential (SMR =1.28) for asbestos exposure had non-significantly elevated mesothelioma mortality., Conclusions: The large excess of mesothelioma deaths seen among atomic veterans was explained by asbestos exposure among enlisted naval personnel. The sources of exposure were determined to be on navy ships in areas (or with materials) with known asbestos content. No excess of mesothelioma was observed in other services or among naval personnel with minimal exposure to asbestos in this low-dose radiation exposed cohort.
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- 2022
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24. Mesothelioma with Nonbacterial Thrombotic Endocarditis: A Case Report.
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Verma A, Bhatta N, Mishra DR, Acharya AB, Shahi R, LImbu SH, Katuwal S, and Lama U
- Subjects
- Adult, Humans, Disseminated Intravascular Coagulation, Endocarditis, Non-Infective diagnosis, Endocarditis, Non-Infective diagnostic imaging, Mesothelioma complications, Mesothelioma diagnosis
- Abstract
Non-bacterial thrombotic endocarditis is a rare condition characterized by noninfectious vegetation on cardiac valves which are often associated with malignancy. It often presents with features of embolism rather than cardiac failure. These are usually seen in autoimmune conditions, disseminated intravascular coagulation, malignancy of gut and lung but has also been reported in other malignancies as well. This entity is rare but one must have a clinical suspicion of the disease especially in a patient suffering from malignancy presenting with the embolic phenomenon. In this report, we are presenting a case of non-bacterial thrombotic endocarditis in an inpatient with pleural mesothelioma, a rare malignant neoplasm arising from pleura in a 35 years old mason, and a rare association as well.
- Published
- 2021
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25. Assessment of Risk of Hereditary Predisposition in Patients With Melanoma and/or Mesothelioma and Renal Neoplasia.
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Gupta S, Erickson LA, Lohse CM, Shen W, Pitel BA, Knight SM, Halling KC, Herrera-Hernandez L, Boorjian SA, Thompson RH, Leibovich BC, Jimenez RE, and Cheville JC
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Germ-Line Mutation, Humans, Kidney Neoplasms complications, Kidney Neoplasms epidemiology, Kidney Neoplasms pathology, Male, Melanoma complications, Melanoma epidemiology, Melanoma pathology, Mesothelioma complications, Mesothelioma epidemiology, Mesothelioma pathology, Middle Aged, Minnesota epidemiology, Proto-Oncogene Proteins, Registries, Genetic Predisposition to Disease epidemiology, Kidney Neoplasms genetics, Melanoma genetics, Mesothelioma genetics, Microphthalmia-Associated Transcription Factor genetics, Tumor Suppressor Proteins genetics, Ubiquitin Thiolesterase genetics
- Abstract
Importance: In BAP1 tumor predisposition syndrome, clear cell renal cell carcinoma (RCC) is frequently associated with melanoma and/or mesothelioma, while germline MITF p.E318K alterations are being increasingly reported in melanoma/RCC. Limited data exist on the co-occurrence of melanoma and/or mesothelioma with renal neoplasia and the prevalence of associated germline alterations., Objective: To assess the frequency of melanoma and/or mesothelioma co-occurring with renal neoplasia using our institutional nephrectomy registry and to determine the prevalence of BAP1 and MITF alterations within this cohort., Design, Setting, and Participants: In this genetic association study, medical records from 8295 patients from 1970 to 2018, renal neoplasia co-occurring with melanoma and/or mesothelioma within a single institutional nephrectomy registry was reevaluated based on contemporary histopathologic criteria and the medical records were reviewed. Data were analyzed from September 2019 to May 2021., Main Outcomes and Measures: Identified cases were screened for BAP1 loss using immunohistochemistry; while patients with melanoma and clear cell RCC were screened for MITF p.E318K alterations. Tumors from patients with potential germline alterations were analyzed with comprehensive molecular profiling using a 514-gene next generation sequencing panel., Results: Of a total of 8295 patients, 93 (1.1%; 95% CI, 0.9%-1.4%) had melanoma and/or mesothelioma co-occurring with renal neoplasia (cutaneous melanoma, n = 76; uveal melanoma, n = 11; mesothelioma, n = 6). A total of 69 (74.2%) were male; 24 (25.8%) were female; median age at diagnosis of renal neoplasia was 63 years (IQR, 58-70 years) and the median duration of follow-up was 8.5 years (IQR, 5.0-14.6 years). Two patients with clear cell RCC had germline BAP1 alterations in the setting of cutaneous melanoma and mesothelioma. Two patients with hybrid oncocytic tumors had biallelic inactivation of FLCN in a setting of Birt-Hogg-Dubé (BHD) syndrome associated with uveal melanoma and mesothelioma. Tumor-only screening of clear cell RCC associated with cutaneous (n = 53) and uveal melanoma (n = 6) led to the identification of 1 patient with a likely germline MITF p.E318K alteration. After excluding benign renal neoplasia (such as oncocytoma and angiomyolipoma), alterations of BAP1, FLCN, and MITF were identified in 5 of 81 patients (6.2%) with melanoma and/or mesothelioma and renal neoplasia. In contrast to hybrid oncocytic tumors in BHD, no unique genotype-phenotype correlations were seen for clear cell RCC with pathogenic BAP1/ MITF alterations and VHL loss of function variants. Four of 5 cases (80%) met current National Comprehensive Cancer Network criteria for germline testing based on a combination of age, multifocality, histologic findings, and family history., Conclusions and Relevance: In this genetic association study, findings support the continued use of these National Comprehensive Cancer Network criteria and suggest more stringent screening may be warranted in this patient population.
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- 2021
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26. Malignant Pleural Effusion in Malignant Pleural Mesothelioma: An Innocent Bystander?
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Muruganandan S and Duong V
- Subjects
- Humans, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma, Malignant, Pleural Effusion, Malignant diagnostic imaging, Pleural Effusion, Malignant etiology, Pleural Neoplasms complications, Pleural Neoplasms diagnosis
- Published
- 2021
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27. Cerebral air embolism after indwelling pleural catheter insertion in a chronic hydropneumothorax secondary to epithelioid mesothelioma.
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Jayawardena DMC, Panchal RK, Agrawal S, and Das I
- Subjects
- Aged, Catheters, Indwelling, Humans, Male, Embolism, Air diagnostic imaging, Embolism, Air etiology, Hydropneumothorax, Mesothelioma complications, Mesothelioma, Malignant, Pleural Effusion, Malignant
- Abstract
A 75-year-old man with a history of epithelioid mesothelioma and a right-sided indwelling pleural catheter (IPC) presented with a history of a purulent fluid drainage via the IPC. The pleural fluid cultured Klebsiella oxytoca and Enterococcus faecalis He was treated with a course of oral fluoroquinolone followed by uneventful IPC replacement. One and half hours postprocedure, the patient had a witnessed drop in conscious level accompanied by seizure like activity. Acute stroke was suspected and a CT head was performed. CT head revealed multiple serpiginous pockets of air along the cerebral fissure, with features that were highly suggestive of cerebral air embolism and multiple wedge-shaped areas of infarction involving the cerebral hemispheres. Further imaging revealed satisfactory position of the replaced IPC. The patient was admitted to the intensive care unit for high flow oxygen therapy and head down ventilation. However, his condition deteriorated and he died later., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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28. Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman.
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Pang B, Hu C, Liu Q, Yu J, Wei Z, and Yu X
- Subjects
- Adult, Female, Humans, Neoplasm Recurrence, Local, Tomography, X-Ray Computed, Infertility, Mesothelioma complications, Mesothelioma diagnostic imaging, Mesothelioma surgery, Peritoneal Neoplasms complications, Peritoneal Neoplasms diagnostic imaging, Peritoneal Neoplasms surgery
- Abstract
Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.
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- 2021
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29. Systemic Listeria monocytogenes infection and concurrent pleural mesothelioma in a cat.
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Elbert JA and Rissi DR
- Subjects
- Animals, Cat Diseases microbiology, Cats, Diagnosis, Differential, Female, Listeriosis complications, Listeriosis diagnosis, Listeriosis microbiology, Mesothelioma complications, Mesothelioma pathology, Pleural Neoplasms complications, Pleural Neoplasms pathology, Cat Diseases diagnosis, Listeria monocytogenes isolation & purification, Listeriosis veterinary, Mesothelioma veterinary, Pleural Neoplasms veterinary
- Abstract
Herein we describe a rare case of systemic Listeria monocytogenes infection with concurrent pleural mesothelioma in a stray cat that was found dead and submitted for autopsy. Gross pathology changes consisted of thoracic clear yellow fluid admixed with suspended fibrin strands; clear-to-tan, variably sized, <3 mm diameter pulmonary nodules; and enlargement of the submandibular, retropharyngeal, and prescapular lymph nodes. Histologic changes consisted of extensive areas of suppurative inflammation and necrosis with mineralization that partially effaced the pulmonary parenchyma and lymph nodes. Random, distinct necrotic foci were present throughout the hepatic parenchyma. Extending from the pleura, within perinecrotic alveolar spaces, and infiltrating the submandibular, retropharyngeal, and prescapular lymph nodes were dense sheets of neoplastic epithelioid cells with moderate pleomorphism and occasional karyomegaly and multinucleation. Neoplastic cells exhibited immunolabeling for pancytokeratin AE1/AE3 and vimentin, consistent with pleural mesothelioma. Aerobic bacterial culture of lung yielded heavy growth of L. monocytogenes . Immunohistochemistry (IHC) for L. monocytogenes revealed clusters of bacteria in the lung, lymph node, and liver. Pathologic changes were consistent with systemic listeriosis, confirmed by bacterial culture and IHC, and concurrent pleural mesothelioma.
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- 2021
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30. Massive Ascites Secondary to Malignant Peritoneal Mesothelioma.
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Huang X, Liao X, and Chen S
- Subjects
- Ascites etiology, Humans, Mesothelioma complications, Mesothelioma diagnosis, Mesothelioma, Malignant, Peritoneal Neoplasms complications, Peritoneal Neoplasms diagnosis
- Published
- 2020
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31. Percutaneous cervical cordotomy for cancer-related pain: national data.
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Poolman M, Makin M, Briggs J, Scofield K, Campkin N, Williams M, Sharma ML, Laird B, and Mayland CR
- Subjects
- Aged, Female, Humans, Male, Mesothelioma complications, Middle Aged, Pain Management, Pain Measurement, Prospective Studies, Quality of Life, Time-to-Treatment, Treatment Outcome, Cancer Pain surgery, Cervical Vertebrae surgery, Cordotomy methods, Minimally Invasive Surgical Procedures methods, Spinal Cord surgery
- Abstract
Objectives: Percutaneous cervical cordotomy (PCC) is an interventional ablative procedure in the armamentarium for cancer pain treatment, but there is limited evidence to support its use. This study aimed to assess the effectiveness and safety of PCC., Methods: Analysis was undertaken of the first national (UK) prospective data repository of adult patients with cancer undergoing PCC for pain treatment. The relationship between pain and other outcomes before and after PCC was examined using appropriate statistical methods., Results: Data on 159 patients' PCCs (performed from 1 January 2012 to 6 June 2017 in three centres) were assessed: median (IQR) age was 66 (58-71) years, 47 (30%) were female. Mesothelioma was the most common primary malignancy (57%). The median (IQR) time from cancer diagnosis to PCC assessment was 13.3 (6.2-23.2) months; PCC to follow-up was 9 (8-25) days; and survival after PCC was 1.3 (0.6-2.8) months. The mean (SD) for 'average pain' using a numerical rating scale was 6 (2) before PCC and 2 (2) at follow-up, and for 'worst pain' 9 (1) and 3 (3), respectively. The median (IQR) reduction in strong opioid dose at follow-up was 50% (34-50). With the exception of 'activity', all health-related quality of life scores (5-level version of EuroQol-5 Dimension) either improved or were stable after PCC. Six patients (4%) had PCC-related adverse events., Conclusions: PCC is an effective treatment for cancer pain; however, findings in this study suggest PCC referrals tended to be late in patients' disease trajectories. Further study into earlier treatment and seeking international consensus on PCC outcomes will further enhance opportunities to improve patient care., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2020
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32. Permanent diabetes insipidus in a patient with mesothelioma treated with immunotherapy.
- Author
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Brilli L, Calabrò L, Campanile M, Pilli T, Agostinis C, Cerase A, Maio M, and Castagna MG
- Subjects
- Aged, Humans, Immunotherapy, Lung Neoplasms, Magnetic Resonance Imaging, Male, Diabetes Insipidus, Neurogenic complications, Mesothelioma complications, Mesothelioma therapy
- Abstract
Checkpoint inhibitors have substantially improved the prognosis for patients with advanced malignancy. Treatment with immunomodulants has the ability to reactivate the immune system against tumor cells, but can also trigger the development of immune-related adverse events that reflects a loss of tolerance of the immune system for self-antigens. Regarding the endocrine system, thyroid and pituitary are the most frequent glands involved; in particular hypophysitis is commonly observed with anti-CTLA4 with a variable impaired anterior pituitary dysfunction (mainly ACTH and TSH dysregulation) while a posterior pituitary dysfunction has been rarely described. A 68-year-old man with a diagnosis of metastatic mesothelioma started in September 2016 first-line treatment with tremelimumab and durvalumab. After 3 cycles he presented sudden onset of polydipsia and polyuria without other symptoms. Diagnostic work-up, including a water deprivation test, established a diagnosis of central diabetes insipidus. Patient started sublingual desmopressin 60 mcg three times a day, that was subsequently increased up to 480 mcg/die. At magnetic resonance imaging the posterior lobe of pituitary gland did not show high signal intensity on T1-weighted images. After regression of diabetes insipidus symptoms under desmopressin, patient restarted cancer treatment and received additional 10 doses without worsening of endocrinological toxicity or further treatment-related toxicities, maintaining the same desmopressin dosage. Posterior pituitary dysfunction has been rarely observed in patients treated with immunomodulants. To our knowledge, this is the first observation of permanent central diabetes insipidus in patients treated with combined immune checkpoint inhibitors (tremelimumab and durvalumab).
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- 2020
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33. Clinically important associations of pleurodesis success in malignant pleural effusion: Analysis of the TIME1 data set.
- Author
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Mercer RM, Macready J, Jeffries H, Speck N, Kanellakis NI, Maskell NA, Pepperell J, Saba T, West A, Ali N, Corcoran JP, Hallifax RJ, Psallidas I, Asciak R, Hassan M, Miller RF, and Rahman NM
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Leukocyte Count, Male, Mesothelioma complications, Middle Aged, Pleural Effusion, Malignant etiology, Pleural Neoplasms complications, Randomized Controlled Trials as Topic, Talc administration & dosage, Thoracoscopy, Treatment Outcome, C-Reactive Protein immunology, Pain immunology, Pleural Effusion, Malignant therapy, Pleurodesis methods
- Abstract
Background and Objective: Chemical pleurodesis is performed for patients with MPE with a published success rate of around 80%. It has been postulated that inflammation is key in achieving successful pleural symphysis, as evidenced by higher amounts of pain or detected inflammatory response. Patients with mesothelioma are postulated to have a lower rate of successful pleurodesis due to lack of normal pleural tissue enabling an inflammatory response., Methods: The TIME1 trial data set, in which pleurodesis success and pain were co-primary outcome measures, was used to address a number of these assumptions. Pain score, systemic inflammatory parameters as a marker of pleural inflammation and cancer type were analysed in relation to pleurodesis success., Results: In total, 285 patients were included with an overall success rate of 81.4%. There was a significantly higher rise in CRP in the Pleurodesis Success group compared with the Pleurodesis Failure group (mean difference: 19.2, 95% CI of the difference: 6.2-32.0, P = 0.004) but no significant change in WCC. There was no significant difference in pain scores or analgesia requirements between the groups. Patients with mesothelioma had a lower rate of pleurodesis success than non-mesothelioma patients (73.3% vs 84.9%, χ
2 = 5.1, P = 0.023)., Conclusion: Change in CRP during pleurodesis is associated with successful pleurodesis but higher levels of pain are not associated. Patients with mesothelioma appear less likely to undergo successful pleurodesis than patients with other malignancies, but there is still a significant rise in systemic inflammatory markers. The mechanisms of these findings are unclear but warrant further investigation., (© 2019 Asian Pacific Society of Respirology.)- Published
- 2020
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34. Mesothelioma in Familial Mediterranean Fever With Colchicine Intolerance: A Case Report and Literature Review.
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Talerico R, Cardillo C, De Vito F, Schinzari F, Soldato M, Giustiniani MC, Verrecchia E, and Manna R
- Subjects
- Aged, Colchicine adverse effects, Familial Mediterranean Fever complications, Familial Mediterranean Fever drug therapy, Homozygote, Humans, Inflammation complications, Inflammation drug therapy, Leukopenia, Male, Mesothelioma complications, Mesothelioma drug therapy, Peritoneum pathology, Polymorphism, Genetic, Tomography, X-Ray Computed, Colchicine therapeutic use, Familial Mediterranean Fever diagnosis, Inflammation diagnosis, Interleukin 1 Receptor Antagonist Protein therapeutic use, Mesothelioma diagnosis, Peritoneum diagnostic imaging, Pyrin genetics
- Abstract
A 65-year-old Italian physician affected by Familial Mediterranean fever (FMF) was hospitalized due to progressive abdominal enlargement, which had begun 6 months before admission. Physical examination revealed ascites and bilateral leg edema. Abdominal CT scan showed ascitic fluid and extensive multiple peritoneal implants; peritoneal CT-guided biopsy revealed an epithelial-type malignant mesothelioma. The patient's past medical history revealed recurrent episodes of abdominal pain and fever from the age of 2. Clinical diagnosis of FMF was suspected at the age of 25, while genetic analysis, performed at the age of 50, confirmed homozygosity for the M694I mutation in the MEFV gene. Treatment with the first line FMF drug colchicine was started and stopped several times because of worsened leukopenia. The patient in fact had a history of asymptomatic leukopenia/lymphopenia from an early age; the intake of colchicine aggravated his pre-existing problem until the definitive suspension of the drug. As for second-line drugs, canakinumab was first prescribed, but due to prescription issues, it was not possible to be administered. When he was given anakinra, there was a worsening of leukopenia leading to septic fever. Systematic literature review indicates that, in most cases, recurrent peritoneal inflammation results in benign peritoneal fibrosis or less commonly in encapsulating peritonitis. There are only a few reported cases of recurrent peritoneal inflammation progressing from FMF to peritoneal mesothelioma (MST). In such cases, intolerance to colchicine or its erratic intake may lead to long-term recurrent inflammation, which usually precedes the development of the tumor, while pre-existing leukopenia, as in our patient, could also be a factor promoting or accelerating the tumor progression. In conclusion, we suggest that in the presence of intolerance or resistance to colchicine, interleukin (IL)-1 inhibition could suppress peritoneal inflammation and prevent MSTs., (Copyright © 2020 Talerico, Cardillo, De Vito, Schinzari, Soldato, Giustiniani, Verrecchia and Manna.)
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- 2020
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35. 99mTc-HDP Bone Scintigraphy, SPECT/CT, and 18F-FDG PET/CT Diagnosis Imaging of Incidental Pleural Mesothelioma in a Patient With Biochemical Recurrences of Prostate Cancer: Is it Really a Coincidence?
- Author
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Fernández-Rodríguez P, Martín-Marcuartu JJ, Acevedo Báñez I, Masero Carretero JM, and Jiménez-Hoyuela García JM
- Subjects
- Aged, Diphosphonates, Fluorodeoxyglucose F18, Humans, Lung Neoplasms complications, Male, Mesothelioma complications, Mesothelioma, Malignant, Organotechnetium Compounds, Pleural Neoplasms complications, Prostatic Neoplasms blood, Radiopharmaceuticals, Lung Neoplasms diagnostic imaging, Mesothelioma diagnostic imaging, Pleural Neoplasms diagnostic imaging, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms complications, Single Photon Emission Computed Tomography Computed Tomography
- Abstract
We present the case of a 69-year-old man with history of prostate carcinoma treated with prostatectomy and subsequently with external beam radiotherapy and hormone therapy because of biochemical recurrences. More than 10 years after the diagnosis, follow-up Tc-HDP bone scans and SPECT/CT images demonstrated an incidental diagnosis of osteoblastic pleural plaques that quickly evolve to mesothelioma. PET/CT achieved the definitive diagnosis by guiding the biopsy to the highest and most accessible focus of glucidic hypermetabolism. Our case report raises the association between prostate cancer patients treated with external beam radiotherapy and the development of pleural mesothelioma despite having no history of exposure to asbestos.
- Published
- 2020
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36. Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature.
- Author
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Drevinskaite M, Patasius A, Kevlicius L, Mickys U, and Smailyte G
- Subjects
- Aged, Biopsy, Cisplatin therapeutic use, Deoxycytidine analogs & derivatives, Deoxycytidine therapeutic use, Disease Progression, Fatal Outcome, Humans, Lung Neoplasms complications, Lung Neoplasms therapy, Lymphadenopathy, Male, Mesothelioma complications, Mesothelioma therapy, Mesothelioma, Malignant, Orchiectomy, Pemetrexed therapeutic use, Prognosis, Testicular Hydrocele etiology, Testicular Neoplasms complications, Testicular Neoplasms therapy, Gemcitabine, Antineoplastic Agents therapeutic use, Lung Neoplasms diagnosis, Mesothelioma diagnosis, Testicular Hydrocele surgery, Testicular Neoplasms diagnosis
- Abstract
Background: Malignant mesothelioma of the tunica vaginalis is a rare tumour which comprises less than 1% of all mesotheliomas., Case Presentation: 69-years old patient with painful hard mass and hydrocele in the right scrotum to whom a right hydrocelectomy was performed. Any history of scrotal trauma or exposure to asbestos was not present. Excisional biopsy revealed a multinodular tumour with focal areas of necrosis and infiltrative growth. According to morphological and immunohistochemical findings, diagnosis of malignant biphasic mesothelioma of the tunica vaginalis testis was made. Two months after hydrocelectomy, right inguinal orchidectomy was performed. Post-surgical whole body CT scan revealed paraaortic and pararenal lymphadenopathy, likely to be metastatic. Adjuvant treatment with 6 cycles of cisplatin and pemetrexed was applied. After 3 cycles of chemotherapy, CT scan showed progression and the treatment was changed to gemcitabine 1 month after., Conclusions: Although malignant mesothelioma of the tunica vaginalis is a rare malignancy, it poses a diagnostic challenge which can mimic common inguinal or scrotal diseases such as hydrocele. Despite aggressive surgical procedures or adjuvant therapies, the prognosis remains poor.
- Published
- 2020
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37. Marked paraneoplastic leukemoid reaction in a patient with mesothelioma mimicking a myeloid neoplasm.
- Author
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Thakral B and Loghavi S
- Subjects
- Bone Marrow pathology, Female, Humans, Leukemoid Reaction complications, Leukemoid Reaction diagnosis, Mesothelioma complications, Mesothelioma diagnosis, Middle Aged, Myeloproliferative Disorders complications, Myeloproliferative Disorders diagnosis, Myeloproliferative Disorders pathology, Peritoneal Neoplasms complications, Peritoneal Neoplasms diagnosis, Leukemoid Reaction pathology, Mesothelioma pathology, Peritoneal Neoplasms pathology
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- 2020
- Full Text
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38. Pericardial Mesothelioma in a 35-Year-Old Male With Ulcerative Colitis.
- Author
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Iliff J, Bart NK, Ghaly S, Granger E, and Holloway CJ
- Subjects
- Adult, Colitis, Ulcerative diagnosis, Colitis, Ulcerative drug therapy, Echocardiography, Fatal Outcome, Heart Neoplasms complications, Heart Neoplasms pathology, Heart Neoplasms surgery, Humans, Magnetic Resonance Imaging, Male, Mesothelioma complications, Mesothelioma pathology, Mesothelioma surgery, Pericardial Effusion etiology, Pericardial Effusion surgery, Pericardiectomy, Pericardium pathology, Pericardium surgery, Positron-Emission Tomography, Predictive Value of Tests, Treatment Outcome, Cardiac Imaging Techniques, Colitis, Ulcerative complications, Heart Neoplasms diagnostic imaging, Mesothelioma diagnostic imaging, Pericardial Effusion diagnostic imaging, Pericardium diagnostic imaging
- Published
- 2019
- Full Text
- View/download PDF
39. A Man in His 20s With Cough, Unilateral Pleural Effusion, and Nodular Pleural Thickening.
- Author
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Sonnick MA, Weisman S, Borczuk AC, and Turetz ML
- Subjects
- Adenocarcinoma of Lung diagnosis, Adult, Asbestos, Bartonella Infections diagnosis, Biopsy, Cough etiology, Diagnosis, Differential, Dyspnea etiology, Environmental Exposure, Humans, Lung Neoplasms complications, Lung Neoplasms pathology, Lymph Nodes diagnostic imaging, Lymphoma, Non-Hodgkin diagnosis, Male, Mesothelioma complications, Mesothelioma pathology, Mesothelioma, Malignant, Palatine Tonsil diagnostic imaging, Pleural Effusion diagnostic imaging, Pleural Effusion etiology, Pleural Effusion, Malignant etiology, Pleural Neoplasms complications, Pleural Neoplasms pathology, Positron-Emission Tomography, Spleen diagnostic imaging, Sweating, Talc, Thoracic Surgery, Video-Assisted, Lung Neoplasms diagnosis, Mesothelioma diagnosis, Pleural Effusion, Malignant diagnostic imaging, Pleural Neoplasms diagnosis
- Abstract
Case Presentation: A man in his 20s presented to the ED after several months of progressive dyspnea, dry cough, and night sweats. He had no chest pain, fevers, weight loss, or sick contacts. He was previously healthy and took no medications. Social history was notable for 5 pack-years of tobacco use. The patient was sexually active with male partners and had a recent partner infected with human T-lymphotropic virus. The patient worked in set design and window installations, and wore a respirator when working around solvents and resins. From ages 2 to 7 years, he frequently visited buildings at his parents' workplace that were undergoing asbestos abatement. From ages 7 to 24 years, he frequently visited pottery studios where talc-containing products were used. He frequently visited northern Massachusetts, and infections with Borrelia burgdorferi and Bartonella henselae were common in family members. His stepfather had recently been infected with Anaplasma. There was no family history of cancer., (Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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- View/download PDF
40. Paraneoplastic Migratory Oligoarthritis in a Patient With Malignant Mesothelioma.
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Eidenschink M, Beard A, and Ewart D
- Subjects
- Aged, Humans, Male, Mesothelioma, Malignant, Arthritis diagnosis, Arthritis etiology, Lung Neoplasms complications, Mesothelioma complications, Paraneoplastic Syndromes diagnosis, Paraneoplastic Syndromes etiology
- Published
- 2019
- Full Text
- View/download PDF
41. A young merchant navy officer with night sweats, fever, and weight loss.
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Pesce A, Magro G, and Puleo S
- Subjects
- Adult, Diagnosis, Differential, Fever etiology, Humans, Lung Neoplasms complications, Male, Mesothelioma complications, Mesothelioma, Malignant, Military Personnel, Occupational Diseases complications, Sweating, Weight Loss, Fever diagnosis, Lung Neoplasms diagnosis, Mesothelioma diagnosis, Occupational Diseases diagnosis, Occupational Exposure adverse effects
- Published
- 2019
- Full Text
- View/download PDF
42. Localized intrapulmonary mesothelioma presenting with a pulmonary mass.
- Author
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Wang T, Cui M, and Thakur A
- Subjects
- Aged, Biopsy, Humans, Lung pathology, Lung Neoplasms etiology, Male, Tomography, X-Ray Computed, Lung Neoplasms diagnostic imaging, Mesothelioma complications, Mesothelioma diagnosis
- Abstract
Competing Interests: None
- Published
- 2019
- Full Text
- View/download PDF
43. A case of primary lung squamous cell carcinoma mimicking malignant mesothelioma producing granulocyte colony stimulating factor with chemotherapy (cisplatin and gemcitabine)-associated thrombotic thrombocytopenic purpura (TTP); An autopsy case report.
- Author
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Suzuki Y, Kanazawa K, Kanai R, Tomita H, Saito M, Watanabe N, Morimoto J, Umeda T, Kawamata T, Rikimaru M, Koizumi T, Togawa R, Sato Y, Hirai K, Uematsu M, Minemura H, Nikaido T, Fukuhara A, Sato S, Saito J, Tanino Y, Mori K, and Shibata Y
- Subjects
- Acute Kidney Injury etiology, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Autopsy, Carcinoma, Squamous Cell drug therapy, Granulocyte Colony-Stimulating Factor biosynthesis, Humans, Lung Neoplasms drug therapy, Male, Mesothelioma drug therapy, Mesothelioma, Malignant, Positron-Emission Tomography, Tomography, X-Ray Computed, Carcinoma, Squamous Cell complications, Carcinoma, Squamous Cell diagnosis, Lung Neoplasms complications, Lung Neoplasms diagnosis, Mesothelioma complications, Mesothelioma diagnosis, Purpura, Thrombotic Thrombocytopenic diagnosis, Purpura, Thrombotic Thrombocytopenic etiology
- Abstract
Objectives: Thrombotic thrombocytopenic purpura (TTP) is a rare form of thrombotic microangiopathy. In recent years, an extensive variety of drugs, including certain cytotoxic agents, have been reported to be associated with TTP. Additionally, several studies have reported that granulocyte colony-stimulating factor (G-CSF) was produced by lung carcinoma. G-CSF-producing carcinoma also produces various other cytokines, which may cause vascular endothelial damage and trigger TTP development. However, there has been no report describing G-CSF-producing carcinoma combined with TTP. We report a rare case of pseudomesothliomatous squamous cell lung carcinoma producing G-CSF along with chemotherapy associated TTP., Materials and Methods: A 66-year-old man with pseudomesotheliomatous primary squamous cell lung carcinoma was treated with chemotherapy consisting of cisplatin and gemcitabine as the first line treatment. However, thrombocytopenia, acute renal dysfunction and acute respiratory failure occurred after starting the first chemotherapy cycle. As a result, the patient died, and an autopsy was performed., Results: According to the autopsy findings, a diagnosis of primary lung squamous cell carcinoma producing G-CSF associated with TTP was made., Conclusion: Chemotherapy-related TTP should be considered when anemia and thrombocytopenia progress rapidly in patients who are under chemotherapy treatment. Furthermore, the current case may provide a possible link between TTP and G-CSF-producing tumor., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
44. Determination of Mesothelin Levels in Pleural Effusion Does Not Help Predict Survival of Patients With Malignant Pleural Mesothelioma.
- Author
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Fontana V, Pistillo MP, Vigani A, Canessa PA, Berisso G, Giannoni U, Ferro P, Franceschini MC, Carosio R, Tonarelli M, Rossi C, Dessanti P, and Roncella S
- Subjects
- Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biomarkers, Tumor, Female, Humans, Lung Neoplasms diagnosis, Lung Neoplasms therapy, Male, Mesothelin, Mesothelioma diagnosis, Mesothelioma therapy, Mesothelioma, Malignant, Middle Aged, Pleural Effusion, Malignant diagnosis, Pleural Effusion, Malignant therapy, Pleural Neoplasms diagnosis, Pleural Neoplasms therapy, Prognosis, ROC Curve, Treatment Outcome, GPI-Linked Proteins metabolism, Lung Neoplasms complications, Lung Neoplasms mortality, Mesothelioma complications, Mesothelioma mortality, Pleural Effusion, Malignant etiology, Pleural Effusion, Malignant metabolism, Pleural Neoplasms complications, Pleural Neoplasms mortality
- Abstract
Aim: This study evaluated the prognostic value of soluble mesothelin-related protein (SMRP) levels in pleural effusions (PE) from patients with pleural mesothelioma (MPM)., Patients and Methods: SMRP level in PE was tested using an enzyme-linked immunosorbent assay (ELISA) in 109 patients with MPM at diagnosis before any treatment. The Kaplan-Meier method and the Cox regression were applied to compare overall survival probabilities across tertile categories of SMRP level., Results: No significant differences in Kaplan-Meier overall survival probabilities among the SMRP categories were found. A statistically non-significant trend for increased death rate ratio (RR) was computed (p=0.327) when the higher (>46.5 nM, RR=1.38) and intermediate (8.5-46.5 nM, RR=1.18) SMRP categories were compared to the lower category (<8.5 nM, RR=1.00). Cox regression modelling including a restricted cubic spline showed a moderately rising non-linear trend in death rate., Conclusion: The SMRP level in PE does not appear to have prognostic significance and its detection is not recommended in routine clinical management of patients with MPM., (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
45. Acute severe abdominal pain in a young woman caused by a well-differentiated papillary mesothelioma of the peritoneum.
- Author
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Bousema JE, van de Luijtgaarden KM, Wilhelmus S, and Poelman MM
- Subjects
- Abdominal Pain etiology, Acute Pain etiology, Adult, Female, Humans, Mesothelioma complications, Peritoneal Neoplasms complications, Abdominal Pain diagnosis, Acute Pain diagnosis, Mesothelioma diagnosis, Peritoneal Neoplasms diagnosis
- Abstract
Acute abdominal pain is a common symptom in young women. We describe a patient with acute illness and severe lower abdominal pain. Laboratory tests were normal except for mildly deranged inflammatory markers. No abnormalities were reported on abdominal ultrasonography and MRI, whereas diagnostic laparoscopy revealed a tumour located dorsally from the uterus. We resected the tumour and pathology results showed a well-differentiated papillary mesothelioma of the peritoneum (WDPMP). Microscopy showed evidence of acute ischaemia in the resected lesion, which was likely the cause of the acute abdominal pain. WDPMP is a rare disease that arises from the serous membranes which does not seem to have a relation to asbestos exposure. Generally, WDPMP has a mild clinical course and good long-term prognosis., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
- Full Text
- View/download PDF
46. The diagnostic role of video-assisted thoracoscopic surgery in exudative pleural effusion and follow-up results in patients with nonspecific pleuritis.
- Author
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Arkin FS, Kutluk AC, Gorgun D, Cansever L, Kocaturk C, Yildiz P, and Bedirhan MA
- Subjects
- Adult, Aged, Biopsy, Exudates and Transudates, Female, Follow-Up Studies, Humans, Lung Neoplasms complications, Lung Neoplasms pathology, Lymphoma complications, Lymphoma pathology, Male, Mesothelioma complications, Mesothelioma pathology, Middle Aged, Pleural Neoplasms complications, Pleural Neoplasms pathology, Pleural Neoplasms secondary, Pleurisy complications, Pleurisy pathology, Retrospective Studies, Thoracentesis, Thoracic Surgery, Video-Assisted, Tuberculosis, Pleural complications, Tuberculosis, Pleural pathology, Turkey, Lung Neoplasms diagnosis, Lymphoma diagnosis, Mesothelioma diagnosis, Pleural Effusion etiology, Pleural Neoplasms diagnosis, Pleurisy diagnosis, Tuberculosis, Pleural diagnosis
- Abstract
Objective: To assess the diagnostic value of video-assisted thoracoscopic surgery in exudative pleural effusions, and to evaluated the frequency of malignancy development with long term follow-up of patients defined as nonspecific pleuritis after surgery. ., Methods: The retrospective study was conducted at Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey, and comprised data of patients with undiagnosed exudative pleural effusions seen between January 2008 and December 2013. Data related to clinical, radiological, thoracoscopical, histopathological and follow-up periods were obtained from the hospital records. SPSS 15 was used for data analysis., Results: Of the 229 patients, 145(63.3%) were males and 84(36.7%) were females. The overall mean age was 54.5 }15.1 years. Malignancy was found in 84 (36.6%) patients, and tuberculosis in 26(11.4%). The remaining 119(52%) patients had nonspecific pleuritis and their mean follow-up period was 29.2}27.1 months (range: 1-103 months). Video-assisted thoracoscopic surgery was repeated in 3(2.52%) patients in the 1st, 4th and 16th months of followup period due to the recurrence of pleural effusion. Tuberculosis and mesothelioma were diagnosed in 1(0.8%) and 2(1.7%) cases, respectively., Conclusions: Video-assisted thoracoscopic surgery was found to be a valuable diagnostic procedure in patients with undiagnosed exudative pleural effusion.
- Published
- 2019
47. Right Flank Pain Caused by a Sigmoid Colon Mass.
- Author
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Su A and Farid M
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma pathology, Biopsy, Colon, Sigmoid diagnostic imaging, Colon, Sigmoid pathology, Diagnosis, Differential, Humans, Intestinal Mucosa diagnostic imaging, Male, Mesothelioma complications, Mesothelioma pathology, Mesothelioma secondary, Middle Aged, Neoplasm Invasiveness, Peritoneal Neoplasms diagnosis, Sigmoid Neoplasms complications, Sigmoid Neoplasms pathology, Sigmoid Neoplasms secondary, Sigmoidoscopy, Flank Pain etiology, Mesothelioma diagnosis, Peritoneal Neoplasms pathology, Sigmoid Neoplasms diagnosis
- Published
- 2019
- Full Text
- View/download PDF
48. Fatal Anti-Ma2 Encephalitis Related to Treatment of Malignant Pleural Mesothelioma With a Combination of Anti-Programmed Death 1 and Anti-Cytotoxic T-Lymphocyte Associated Protein 4 Antibodies.
- Author
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Du Rusquec P, Peyre A, Toulgoat F, Honnorat J, and Raimbourg J
- Subjects
- Aged, Antibodies, Monoclonal, Humanized pharmacology, Encephalitis pathology, Humans, Lung Neoplasms pathology, Male, Mesothelioma pathology, Mesothelioma, Malignant, Antibodies, Monoclonal, Humanized adverse effects, CTLA-4 Antigen therapeutic use, Encephalitis chemically induced, Lung Neoplasms complications, Mesothelioma complications
- Published
- 2019
- Full Text
- View/download PDF
49. Prospective Study of the Utility of Computed Tomography Triage of Pleural Biopsy Strategies in Patients With Pleural Diseases.
- Author
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Metintas M, Ak G, Metintas S, Yildirim H, Dündar E, and Rahman N
- Subjects
- Adult, Aged, Aged, 80 and over, Algorithms, Female, Humans, Male, Mesothelioma complications, Mesothelioma pathology, Middle Aged, Patient Selection, Pleura diagnostic imaging, Pleura pathology, Pleural Effusion etiology, Pleural Neoplasms complications, Pleural Neoplasms pathology, Pleural Neoplasms secondary, Predictive Value of Tests, Prospective Studies, Thoracoscopy, Triage, Tuberculosis, Pleural complications, Tuberculosis, Pleural pathology, Young Adult, Image-Guided Biopsy adverse effects, Image-Guided Biopsy methods, Mesothelioma diagnostic imaging, Pleural Effusion diagnostic imaging, Pleural Neoplasms diagnostic imaging, Tomography, X-Ray Computed, Tuberculosis, Pleural diagnostic imaging
- Abstract
Background: This study aimed to prospectively evaluate the efficacy and reliability of a diagnostic workup, triaging pleural biopsy method according to baseline computerized tomography (CT) findings in the diagnosis of pleural diseases., Methods: Patients with pleural pathology were divided into 3 arms according to findings on CT scan images. Arm A: patients with pleural thickening/lesion in addition to pleural effusion. These patients underwent CT scan-guided Abrams' needle pleural biopsy. Arm B: patients with pleural effusion alone or suspected benign asbestos pleurisy. This group underwent medical thoracoscopy (MT). Arm C: patients with only pleural thickening. This group underwent ultrasonography-guided cutting needle pleural biopsy. MT was planned in patients who did not have a specific diagnosis in the CT scan-guided Abrams' needle pleural biopsy group. When patients with a histopathologic diagnosis of fibrinous pleuritis after MT were assessed in terms of the risk factors for malignant pleural diseases, we offered a further invasive procedure., Results: A total of 164 patients were enrolled in the study. Diagnostic sensitivity after the initial procedure was 90.2% in Arm A, 93.3% in Arm B, 95.2% in Arm C, and 92.4% in the entire workup. The negative predictive value of the entire workup was 90.4% for malignant pleural mesothelioma, 97.1% for metastatic malignant pleural diseases, and 100% for tuberculous pleurisy. Five cases who had a diagnosis of fibrinous pleuritis after MT were detected to have risk factors, 4 of which (80%) indicated malignant disease. Complication rates were low and acceptable., Conclusion: Use of CT scans to triage an appropriate pleural biopsy method is associated with high diagnostic success. We recommend that the proposed diagnostic workup in this study may be used as a diagnostic algorithm for pleural diseases that require a histopathologic analysis. Determination of risk factors predicting malignant disease in patients where fibrinous pleuritis is reported after MT would be useful for clinical practice.
- Published
- 2019
- Full Text
- View/download PDF
50. Paraneoplastic phenomenon in mesothelioma.
- Author
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Waqar AB, Menzies D, Casey M, and Doran M
- Subjects
- Aged, Biopsy, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Male, Mesothelioma diagnostic imaging, Mesothelioma pathology, Mesothelioma, Malignant, Pleural Effusion, Malignant etiology, Tomography, X-Ray Computed, Lung Neoplasms complications, Mesothelioma complications, Ophthalmoplegia etiology, Paraneoplastic Syndromes, Ocular etiology
- Abstract
A 71-year-old man presented with breathlessness and visual disturbance. On examination of the chest, he had signs suggestive of a right-sided pleural effusion and a neurological examination yielded conjugate vertical gaze palsy. Subsequent investigations revealed pleural thickening and mesothelioma. His anti-Ma2 antibodies were positive indicating a paraneoplastic syndrome as the cause of the vertical gaze palsy., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
- Full Text
- View/download PDF
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