STRN-ALK rearranged malignant peritoneal mesothelioma—Presenting with bilateral extensive pelvic masses in a young woman: Mimicking low-grade serous ovarian carcinoma

Malignant peritoneal mesothelioma (MPM) is an exceptionally rare tumor type. Although some somatic/germline genetic alterations including BAP1 loss have been identified in some cases, the molecular properties of MPMs are remained poorly understood. In recent years, anaplastic lymphoma kinase (ALK) gene rearrangement was revealed in a subset of (3.4%) MPMs. Low-grade serous carcinomas (LGSCs) are a rare subtype of ovarian carcinoma and have some morphologic and immunophenotypic overlapping features with MPMs and this may cause misdiagnosis in daily practice. Here, we report a case of 18-year-old women with STRN-ALK-rearranged MPM and no previous exposure to asbestos. This case was presented with bilateral pelvic masses and histologically was displaying pure papillary morphology with mild-to-moderate nuclear atypia, psammoma bodies, and diffuse PAX8 expression as LGSCs. With the detection of ALK alteration in some of the MPMs, a targeted treatment option has emerged for these unusual tumor types.

Survival analysis of 36 patients with malignant mesothelioma / 预防医学

Objective @#To analyze the survival of patients with malignant mesothelioma, so as to provide insights into the management of malignant mesothelioma.@*Methods @#Totally 36 patients with malignant mesothelioma admitted to Cixi Third People’s Hospital from October 2012 to January 2021 were enrolled, and the demographic features, exposure to asbestos, and diagnosis and treatment were retrospectively reviewed. The survival rate and median survival time were calculated with the life-table method, and the factors affecting the survival rate of malignant mesothelioma were identified using the Kaplan-Meier estimate and log-rank test.@*Results @#The 36 patients with malignant mesothelioma included 6 men ( 16.67% ) and 30 women ( 83.33% ), and had a median age of 61 ( interquartile range, 14 ) years. There were 30 cases with pleural malignant mesothelioma ( 83.33% ) and 6 cases with peritoneal malignant mesothelioma ( 16.67% ), 32 cases ( 88.89% ) with a history of occupational exposure to asbestos, and 26 cases ( 72.22% ) receiving palliative treatment. The 1-, 2- and 3-year cumulative survival rates were 30%, 15% and 3%, respectively, and the median survival time was 0.71 years. In addition, there were no significant differences in the survival period among patients with malignant mesothelioma in terms of gender, age, route of asbestos exposure, duration of asbestos exposure, pathogenic site and treatment regimens ( P>0.05 ).@*Conclusion @#The 36 patients with malignant mesothelioma had a median survival period of 0.71 years, and no association was found between the survival period and asbestos exposure or pathogenic site.

Malignant Peritoneal Mesothelioma -An Unforgotten Abdominal Malignancy

Malignant peritoneal mesothelioma is a rare lethal malignancy of the serosal membranes of the peritoneum. The pathogenesis and association is strongly related with industrial pollutants asbestos, but less than pleural mesothelioma. Symptoms are nonspecific and related to the tumor spread within the abdominal cavity. CT scan is the investigation of choice and mostly disease is discovered incidentally on routine imaging. Diagnosis is confirmed on histopathology as well as immunohistochemical analysis of markers. The mainstay of treatment is cytoreductive surgery with Hyperthermic intraperitoneal chemotherapy. Here we present a very unusual case of malignant peritoneal mesothelioma diagnosed on routine evaluation of a 62 year old male admitted in emergency for obstructed inguinal hernia. Introduction: Malignant peritoneal Mesothelioma MPM is a very rare malignancy of the abdominal cavity. Mesotheliomas usually originate from the serosal membrane of different body cavities. Pleura is most commonly affected by mesothelioma followed by peritoneum and also other cavities pericardium and tunica vaginalis testis.10 to 30% of all mesothelioma affects peritoneum. Malignant peritoneal mesothelioma is a highly lethal malignant tumor of peritoneum and its pathogenesis is strongly related with industrial pollutant asbestos exposure. Diagnosis is difficult in most of the cases because of its nonspecific presentation and detected on routine abdominal imaging or Surgery.

Cytotoxic, apoptotic and cell migration inhibitory effects of atranorin on SPC212 mesothelioma cells

Objective: To investigate the effects of atranorin, a lichen secondary metabolite, on SPC212 malignant mesothelioma cells in vitro. Methods: SPC212 malignant mesothelioma cell line was used. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to evaluate cytotoxic effects of atranorin and cisplatin at 24, 48 and 72 h. Hematoxylin-eosin staining and 4',6-diamidino-2-phenylindole, dihydrochloride staining were used for determining cell and nucleus morphology, respectively. Wound healing assay was used for investigating cell migration. The xCELLigence real-time cell analysis system was used for determining cell proliferation. Results: Atranorin at 5-450 μΜ decreased cell viability at 24, 48 and 72 h. IC

Cytotoxic, apoptotic and cell migration inhibitory effects of atranorin on SPC212 mesothelioma cells

Objective: To investigate the effects of atranorin, a lichen secondary metabolite, on SPC212 malignant mesothelioma cells in vitro. Methods: SPC212 malignant mesothelioma cell line was used. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to evaluate cytotoxic effects of atranorin and cisplatin at 24, 48 and 72 h. Hematoxylin-eosin staining and 4',6-diamidino-2-phenylindole, dihydrochloride staining were used for determining cell and nucleus morphology, respectively. Wound healing assay was used for investigating cell migration. The xCELLigence real-time cell analysis system was used for determining cell proliferation. Results: Atranorin at 5-450 μM decreased cell viability at 24, 48 and 72 h. IC50 values of atranorin were 300.94, 292.6 and 278.02 μM at 24, 48 and 72 h, respectively; meanwhile, the IC50 values of cisplatin were 128.00, 34.37 and 17.05 μM at 24, 48 and 72 h, respectively. Furthermore, atranorin disrupted cell and nuclear morphology with increasing concentrations. Atranorin significantly reduced cell migration by 38%, 37% and 35% at 300, 250 and 200 μM, respectively (P＜0.000). Atranorin at 160-450 μM decreased cell proliferation at 72 h (P＜0.000). Conclusions: Atranorin has cytotoxic, antiproliferative, apoptotic and cell migration inhibitory effects on SPC212 malignant mesothelioma cancer cells.

Surgical Options for Malignant Mesothelioma: A Single-Center Experience

BACKGROUND: We investigated the surgical outcomes of patients who underwent therapeutic surgery for malignant pleural mesothelioma (MPM) at a single center. METHODS: A retrospective review of 21 patients who underwent therapeutic surgery for MPM from January 2001 to June 2015 was conducted to assess their outcomes. The patients' characteristics and postoperative course, including complications, mortality, overall survival, and recurrence-free survival, were analyzed. RESULTS: Of the 21 patients who underwent therapeutic surgery, 15 (71.4%) underwent extrapleural pneumonectomy, 2 pleurectomy (9.5%), and 4 excision (19.1 %). The median age was 57 years (range, 32–79 years) and 15 were men (71.4%). The mean hospital stay was 16 days (range, 1–63 days). Median survival was 14.3 months. The survival rate was 54.2%, 35.6%, and 21.3% at 1, 3, and 5 years, respectively. In patients' postoperative course, heart failure was a major complication, occurring in 3 patients (14.3%). The in-hospital mortality rate was 2 of 21 (9.5%) due to a case of severe pneumonia and a case of acute heart failure. CONCLUSION: A fair 5-year survival rate of 21.3% was observed after surgical treatment. Heart failure was a major complication in our cohort. Various surgical methods can be utilized with MPM, each with its own benefits, taking into consideration the severity of the disease and the comorbidities of the patient. Patients with local recurrence may be candidates for surgical intervention, with possible satisfying results.

The characteristics of asbestos-related disease claims made to the Korea Workers' Compensation and Welfare Service (KCOMWEL) from 2011 to 2015

BACKGROUND: This study aimed to enhance understanding of the epidemiologic characteristics of asbestos-related diseases, and to provide information that could inform policy-making aimed at prevention and compensation for occupational asbestos exposure, through analyzing asbestos-related occupational disease claims to Korea Workers’ Compensation and Welfare Service from 2011 to 2015. METHODS: We analyzed 113 workers who filed medical care claims or survivor benefits for asbestos exposure and occupational-related disease from 2011 to 2015. Among these claims, we selected approved workers’ compensation claims relating to malignant mesothelioma and lung cancer, and analyzed the general characteristics, exposure characteristics, pathological characteristics, and occupation and industry distribution. RESULTS: Malignant mesothelioma and lung cancer occurred predominantly in males at 89.7 and 94%, respectively. The mean age at the time of diagnosis for malignant mesothelioma and lung cancer was 59.5 and 59.7 years, respectively, while the latency period for malignant mesothelioma and lung cancer was 34.1 and 33.1 years, respectively. The companies involving exposed workers were most commonly situated within the Busan-Ulsan-Gyeongnam region. Histology results for lung cancer indicated adenocarcinoma as the most common form, accounting for approximately one half of all claims, followed by squamous cell carcinoma, and small cell lung cancer. The most common occupation type was construction in respect of malignant mesothelioma, and shipbuilding in respect of lung cancer. CONCLUSIONS: Considering the long latency period of asbestos and that the peak period of asbestos use in Korea was throughout the mid-1990s, damage due to asbestos-related diseases is expected to show a continued long-term increase. Few studies providing an epidemiologic analysis of asbestos-related diseases are available; therefore, this study may provide baseline data to assist in predicting and preparing for future harm due to asbestos exposure. TRIAL REGISTRATION: DUIH 2018–02–004-001. Registered 28 Februrary 2018.

Análise da qualidade de um registro de base populacional ao notificar casos de câncer potencialmente relacionados ao amianto / Analysis of the quality of a Population-Based Registry in reporting cases of cancer potentially related to asbestos

Esta pesquisa teve como objetivos analisar se os casos de câncer potencialmente relacionados ao amianto estão de acordo com o diagnóstico apresentado no Registro de Câncer de Base Populacional e verificar a sensibilidade e especificidade dos dados e relacionados às notificações e declarações de óbito. Trata-se de um estudo descritivo, retrospectivo e transversal, realizado em um registro de câncer de base populacional e em 11 fontes notificadoras, compreendendo hospitais, clínicas de anatomia patológica, unidade básica de saúde e no sistema de informação de mortalidade na cidade de Curitiba, Paraná. A amostra foi composta por 270 notificações de pacientes adultos com câncer de topografia C38 e C48. A coleta de dados foi referente às notificações de diagnóstico de câncer do período de janeiro de 1998 a dezembro de 2012. Para as análises estatísticas foi utilizado o software Stata 14®. Os resultados evidenciaram que, entre os cânceres estudados, 40,3% eram de peritônio e retroperitônio, 24,5% de mediastino e 11,5% de pleura e mesotelioma maligno. A média de idade dos pacientes com câncer de pleura e mesotelioma maligno foi de 66,3 anos, sete (70%) eram do sexo masculino, nove (90%) não possuíam registro sobre ocupação no prontuário e o tempo médio entre a data do diagnóstico e o óbito foi de 11,6 meses. Quanto à sensibilidade do registro com a notificação de câncer de pleura e mesotelioma maligno, esta foi de 100% e 50%, respectivamente. Em relação à especificidade, o registro apresentou 90% de concordância das notificações. Referente às notificações dos meios diagnósticos, os dados frequentes foram: histologia de tumor primário com 71,9% (n=194) e por declarações de óbito com 20,4% (n=55). Esses resultados expressam que não houve subnotificação para casos de mesotelioma maligno. Contudo, uma alta sobre a estimativa foi observada nas notificações de cânceres de pleura, decorrente da codificação equívoca da descrição da doença por parte do registro. Os resultados da pesquisa foram parcialmente de boa qualidade.

Esta investigación tuvo como objetivos, analizar si los casos de cáncer potencialmente relacionados con el amianto están de acuerdo con el diagnóstico presentado en el Registro de Cáncer de Base Poblacional, verificar la sensibilidad y especificidad de los datos y relacionarlos con las notificaciones y declaraciones de óbito. Se trata de un estudio descriptivo, retrospectivo y transversal, realizado en un registro de cáncer de base poblacional, con 11 fuentes de notificación que abarca hospitales, clínicas de anatomía patológica, unidad básica de salud y el sistema de información de mortalidad en la ciudad de Curitiba, Paraná. La muestra estuvo conformada por 270 notificaciones de pacientes adultos con cáncer de topografía C38 y C48. La recopilación de datos se refiere a las notificaciones de diagnóstico de cáncer durante el período comprendido entre enero de 1998 y diciembre de 2012. Para los análisis estadísticos se utilizó el software Stata 14®. Los resultados evidenciaron que entre los cánceres estudiados, 40,3% eran de peritoneo y retroperitoneo, 24,5% de mediastino y 11,5% de pleura y mesotelioma maligno. El promedio de edad de los pacientes con cáncer de pleura y mesotelioma maligno fue de 66,3 años, siete (70%) eran del sexo masculino, nueve (90%) no tenían registro sobre ocupación en la historia clínica. El tiempo promedio entre la fecha del diagnóstico y el óbito fue 11,6 meses. Con relación a la sensibilidad del registro con la notificación de cáncer de pleura y mesotelioma maligno, esta fue de 100% y 50% respectivamente. Con relación a la especificidad, el registro presentó 90% de concordancia de las notificaciones. En lo referente a las notificaciones de los medios diagnósticos, los datos frecuentes fueron: histología de tumor primario con 71,9% (n=194) y por declaraciones de óbito con 20,4% (n=55). Esos resultados expresan que no hubo subnotificación para casos de mesotelioma maligno. Sin embargo, se observó una alta sobrevaloración en las notificaciones de cánceres de pleura, resultante de la codificación equívoca de la descripción de la enfermedad por parte del registro. Los resultados de la investigación fueron parcialmente de buena calidad.

This research had as its objectives to analyze if the cancer cases are potentially related to asbestos according to the presented diagnosis by the registry of Cancer and Population Bases, and to verify the sensitivity and specificity of the data related to the notifications and statements of death. This is a descriptive, retrospective, and crosssectional study carried out in a population-based cancer registry and in 11 notifying sources such as hospitals, clinics of pathological anatomy, basic health units and in the mortality data system from the city of Curitiba located in the state of Paraná. The sample was composed by 270 notifications of adult patients with C38 and C48 topography cancer. The data collection had been done by searching for cases rated as cancer diagnosis reported from January 1998 to December 2012. Stata 14® software was used for the statistical analysis. The results clearly has shown that among the studied cases 40.3% were of peritoneum and retroperitoneum, 24.5% of mediastinum and 11, 5% of pleura and malignant mesothelioma. The average age of patients with pleural cancer and malignant mesothelioma was 66.3 years, seven (70%) were male, nine (90%) had no record of occupation on their medical records and the average time between the diagnostic and the death was 11.6 months. About the sensitivity from the registry with a notification of cancer of pleura and malignant mesothelioma, it was of 100% and 50% respectively. Regarding the specificity, the registry presented 90% an agreement of the notifications. Referring to the reports of the diagnostic ways, the frequent data has shown a histology of primary tumor with 71.9% (n = 194) and death declarations with 20.4% (n = 55). These results express that there was not underreporting for the cases of malignant mesothelioma. However, a high over estimate was noticed in reports of pleural cancers, as a result of the wrong coding of the disease description by the registry. The results of the survey were partially from good quality.

Estudo retrospectivo dos registros de mesotelioma maligno no período de 1995 a 2015 / Retrospective study of malignant mesothelioma records from 1995 to 2015

RESUMO : O objetivo deste estudo foi analisar os casos registrados de mesotelioma maligno em um hospital oncológico do Paraná no período de 1995 a 2015. Foram analisados 142 prontuários do Registro Hospitalar de Câncer de um Centro de Alta Complexidade em Oncologia de Curitiba, Paraná, registrados com os códigos topográficos C38 e C48. A coleta de dados ocorreu na instituição entre agosto de 2016 e julho de 2017, com a utilização de instrumento elaborado para a pesquisa. Para a manipulação dos dados e análises estatísticas utilizou-se o software Stata 14®. Foram identificados 16 casos de mesotelioma maligno, com 11 casos pleurais e cinco casos peritoneais. Foi observada maior prevalência em homens brancos, casados, com mais de 50 anos de idade, procedentes de Curitiba e com segundo grau de escolaridade. As ocupações relatadas na admissão foram variadas, com relato de exposição ocupacional ao amianto de apenas um paciente. Não foi possível estabelecer o perfil ocupacional devido à ausência de informações complementares. Em sete Declarações de Óbito as causas básicas dos óbitos eram diferentes dos diagnósticos registrados nas evoluções. Os principais sintomas relatados na busca por atendimento foram emagrecimento, dispneia e dor. Em 68,8% dos casos o tumor apresentava estádio IV, o que denota busca tardia por assistência. O tratamento utilizado foi paliativo multimodal, sendo a quimioterapia o tratamento de eleição em 68,8%. A Sensibilidade dos registros da doença foi de 81%, uma vez que três casos foram notificados com topografias inadequadas. A Especificidade foi de 97%. Divergências encontradas entre alguns diagnósticos estabelecidos em prontuários e os repassados ao Sistema de Informação de Mortalidade e Registro Hospitalar de Câncer apontam para a possibilidade de subnotificação e a necessidade de treinamentos sobre completude de registros e o uso de códigos de classificação de doenças.

Abstract: The objective of this study was to describe the reported cases of Malignant Mesothelioma at a cancer hospital in Paraná between 1995 and 2015. A total of 142 medical records of a Hospital Registry of Cancer of the Center of High Complexity in Oncology in Curitiba. Were analyzed, in which 142 were registered with the topographic codes C38 and C48. Data collection took place between August 2016 and July 2017, with the use of an instrument developed by the researcher. For the manipulation of the data and statistical analysis was used the software Stata 14®. Sixteen cases of Malignant Mesothelioma were identified, with 11 pleural cases and five peritoneal cases. It was observed a higher prevalence in white men, married, over 50 years old, coming from Curitiba and with a second degree of education. The occupations reported on admission were varied, with reports of occupational exposure to asbestos from only one patient. It was not possible to establish the occupational profile due to the lack of complementary information. In seven death certificates the basic causes of death were different from the diagnoses recorded in the evolutions. The main symptoms reported in the search of care were weight loss, dyspnea and pain. In 68.8% of the cases the tumor presented stage IV, denoting a late search by the patient for assistance. The treatment used was multimodal palliative, with chemotherapy being the treatment of choice in 68.8%. The sensitivity of the disease records was 81%, since three cases were reported with inadequate topographies. Specificity was 97%. Divergences were found between some diagnoses established in medical records and those passed on to the Mortality Information System and Cancer Hospital Registry pointed to the possibility of underreporting and the need for training on completeness of registries and use of disease classification codes.

RESUMEN: El objetivo de este estudio fue describir los casos registrados de mesotelioma maligno en un hospital oncológico del Paraná entre 1995 y 2015. Se analizaron 142 historias clínicas de un Registro Hospitalar de Cáncer de un Centro de Alta Complejidad en Oncología de Curitiba, que fueron registrados con los códigos topográficos C38 y C48. La colecta de datos se realizó entre agosto de 2016 y julio de 2017, con utilización de instrumento elaborado por la investigadora. Para la manipulación de los datos y el análisis estadístico se utilizó el software Stata 14®. Se identificaron 16 casos de mesotelioma maligno,11 casos pleurales y cinco peritoneales. Se observó mayor prevalencia en hombres blancos, casados, de más de 50 años de edad, procedentes de Curitiba, con escolaridad correspondiente a la enseñanza secundaria. Las ocupaciones relatadas en la admisión fueron variadas, solamente un paciente relató exposición ocupacional al amianto. No fue posible establecer el perfil ocupacional debido a la ausencia de informaciones complementarias. En siete Declaraciones de Óbito las causas básicas de estos óbitos eran diferentes de los diagnósticos registrados en las evoluciones. Los principales síntomas relatados al buscar atendimiento fueron adelgazamiento, dispneia y dolor. En 68,8% de los casos el tumor presenta estadio IV, lo que denota búsqueda de asistencia tardía. El tratamiento utilizado fue paliativo multimodal, siendo la quimioterapia el tratamiento elegido en 68,8% de los casos. La Sensibilidad de los registros de la enfermedad fue de 81%, ya que tres casos fueron notificados con topografías inadecuadas. La Especificidad fue de 97%. Divergencias encontradas entre algunos diagnósticos establecidos en historias clínicas y los enviados al Sistema de Información de Mortalidad y Registro Hospitalar de Cáncer indican posible subnotificación y necesidad de capacitación sobre completitud de registros y uso de códigos de clasificación de enfermedades.

MRI features of malignant mesothelioma / 实用放射学杂志

Objective To investigate the MRI features of malignant mesothelioma(MM).Methods MRI data of 18 cases of MM confirmed by pathology were analyzed retrospectively.1 5 cases were malignant pleural mesothelioma,and 3 cases malignant peritone-um mesothelioma.MRI scans were performed in all cases,including MRI plain scan,MRI enhancement and diffusion weighted ima-ging(DWI).We evaluated the location,shape,size,signal,enhancement mode,dispersion characteristics,invasions of surrounding tissues and concomitant changes of MM.Results Among the 15 cases of malignant pleural mesothelioma,14 cases were diffuse type, 1 case was localized type,and 3 cases of malignant peritoneum mesothelioma were all diffuse types.10 of 14 diffuse malignant pleural mesothelioma had a thickening pleural of more than 3 cm,the average thickness was (5.3±3.8)cm,in which soft tissue mass was showed in 6 cases.2 of 3 diffuse malignant peritoneum mesotheliom had a thickening peritoneal of more than 3 cm with soft tissue mass.On T1 WI images,slightly low signal were showed in 7 cases,and equal signal in 1 1 cases.On T2 fat suppression sequence,low signal were showed in 4 cases,slightly high signal in 10 cases and high signal in 4 cases.On DWI,18 cases of MM lesions all showed high signal.On enhanced scan,continuous enhancement were showed in 1 8 cases of MM and the enhancement was the most obvious at 180 s.8 cases with lymph node enlargement (8/18).The diseased lateral thoracic profile was significantly narrowed in 11 cases with malignant pleural mesothelioma,of which 7 cases with chest wall invasion.Conclusion The MRI features of MM have certain char-acteristics,and MRI examination will help to make accurate diagnosis before treatment.

Cutaneous Metastases of Malignant Pleural Mesothelioma / 대한피부과학회지

No abstract available.

Malignant mesothelioma mistaken for tuberculous pleurisy / 영남의대학술지

Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.

Clinical and Prognostic Features of Erionite-Induced Malignant Mesothelioma

This review analytically examines the published data for erionite-related malignant pleural mesothelioma (E-MPM) and any data to support a genetically predisposed mechanism to erionite fiber carcinogenesis. Adult patients of age > or =18 years with erionite-related pleural diseases and genetically predisposed mechanisms to erionite carcinogenesis were included, while exclusion criteria included asbestos- or tremolite-related pleural diseases. The search was limited to human studies though not limited to a specific timeframe. A total of 33 studies (31042 patients) including 22 retrospective studies, 6 prospective studies, and 5 case reports were reviewed. E-MPM developed in some subjects with high exposures to erionite, though not all. Chest CT was more reliable in detecting various pleural changes in E-MPM than chest X-ray, and pleural effusion was the most common finding in E-MPM cases, by both tests. Bronchoalveolar lavage remains a reliable and relatively less invasive technique. Chemotherapy with cisplatin and mitomycin can be administered either alone or following surgery. Erionite has been the culprit of numerous malignant mesothelioma cases in Europe and even in North America. Erionite has a higher degree of carcinogenicity with possible genetic transmission of erionite susceptibility in an autosomal dominant fashion. Therapeutic management for E-MPM remains very limited, and cure of the disease is extremely rare.

Case of Malignant Mesothelioma of the Peritoneum and Pleura / 대한내과학회지

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

Mesotelioma Maligno Testicular / Malignant Testicular Mesothelioma

El mesotelioma maligno es un tumor adenomatoide de la línea de células no germinales, una neoplasia testicular muy rara, tan solo unos 100 casos han sido reportados en la literatura y la mayoría de los pacientes con este problema son mayores de 50 años. Más del 50% tienen el antecedente de exposición a los asbestos. Todos los pacientes con sospecha de un tumor maligno testicular deben someterse a una orquiectomía radical para evitar recidivas. Presentamos el caso clínico de un paciente de sexo masculino de 69 años de edad que acudió a consulta con un cuadro de 6 meses de evolución con aumento de volumen del escroto izquierdo y drenaje de líquido serohemático a través de un orificio fistuloso. Al paciente se le realizó el tratamiento quirúrgico mediante orquiectomía radical más hemiescrotectomía izquierda y finalmente el examen histopatológico evidenció un mesotelioma maligno testicular mixto.

Malignant mesothelioma is an adenomatoid tumor of non-germ line cells, a very rare testicular tumor, only about 100 cases have been reported in the literature and most patients with this condition are over 50 years. Over 50% had a history of asbestos exposure. All patients with suspected testicular malignancy should get a radical orchiectomy to prevent recurrences. We report a clinic case of a male patient of 69 years who consulted with a disease of 6 months duration with increased volume of left scrotum and serohematic fluid drainage through a fístula. The patient received surgical treatment with a radical orchiectomy and left hemiescrotectomy, histopathological examination revealed a mixed testicular malignant mesothelioma.

Malignant Mesothelioma Presenting as a Giant Chest, Abdominal and Pelvic Wall Mass

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

Epidemiologic Characteristics of Malignant Mesothelioma in Korea

Malignant mesothelioma is an aggressive tumor occurring in mesothelial cells of the pleura and peritoneum. This cancer is attributable to asbestos in 80~90% of the patients. Asbestos has been widely used in Korea since the 1970s, therefore, a large number of Korean workers, especially who engaged in the industries of asbestos textiles, shipbuilding, or construction, have been exposed to asbestos occupationally. Korea has several kinds of statistics showing mesothelioma mortality and morbidity, which include cancer registry data, mortality data, and surveillance data. According to the annual report of the Korea Central Cancer Registry (KCCR), fatal malignant mesothelioma occurred in around 40~50 cases a year during the recent 10 years (1993~2002). According to the surveillance data, about 34 cases have been reported annually since 2001. It has also been revealed that about 60% of malignant mesothelioma patients have experiences to be exposed to asbestos in the past. The number of mesothelioma patients in Korea is smaller than that of some developed countries such as United Kingdom, Germany, and Japan. However, mesothelioma has increased greatly in recent years in Korea, and it is expected to increase continuously considering asbestos consumption, as it happened in other countries which used large amounts of asbestos. Therefore, active policies to prevent asbestos-related malignant mesothelioma and to compensate patients suffering from it have to be made in Korea.

Pathological Diagnosis of Malignant Mesothelioma

Malignant mesothelioma is a primary tumor of the serosal membranes, occurring in the pleura, peritoneum, pericardium, tunica vaginalis, and other related anatomical sites. It is well known that malignant mesothelioma may be a difficult tumor to diagnose pathologically. For the reliable diagnosis of mesothelioma, the adequate representative tissue samples are essential for the routine histology, histochemistry, electron microscopy, and immunohistochemical test. The main differential diagnosis includes metastatic adenocarcinomas or metastatic sarcomas, and even benign mesothelial diseases. As a practical diagnostic method for differential diagnosis of malignant mesothelioma, the immunohistochemistry using a panel of antibodies (positive and negative markers) is considered as the most valuable and useful tool. The use of at least 2 mesothelial markers and 2 or more epithelial markers is recommended, and a diagnostic panel including calretinin, Wilms tumor product 1, cytokeratin 5/6, carcinoembryonic antigen (CEA), and thyroid transcription factor (TTF)-1 could be helpful.

Two cases of malignant mesothelioma of the peritoneum and pericardium / 대한산부인과학회지

Malignant mesothelioma is a rare neoplasm and arises from the serosal lining of the pleural, peritoneal and pericardial cavities. The median survival rang from 5 to 12 months, mainly because of lack of effective treatment. The incidence is approximately one per 1,000,000 and peritoneal mesothelioma represents one fourth of all mesotheliomas. There is a relationship between mesothelioma and asbestos exposure, but non-asbestos related cases were reported. Treatments of malignant mesothelioma are cytoreductive surgery and adjuvant chemotherapy, but current treatment options are unsatisfactory. We report two cases of malignant mesothelioma of the peritoneum and pericardium treated by operation and adjuvant chemotherapy with a brief review of literature.

Two cases of malignant mesothelioma of the peritoneum and pericardium / 대한산부인과학회지

Malignant mesothelioma is a rare neoplasm and arises from the serosal lining of the pleural, peritoneal and pericardial cavities. The median survival rang from 5 to 12 months, mainly because of lack of effective treatment. The incidence is approximately one per 1,000,000 and peritoneal mesothelioma represents one fourth of all mesotheliomas. There is a relationship between mesothelioma and asbestos exposure, but non-asbestos related cases were reported. Treatments of malignant mesothelioma are cytoreductive surgery and adjuvant chemotherapy, but current treatment options are unsatisfactory. We report two cases of malignant mesothelioma of the peritoneum and pericardium treated by operation and adjuvant chemotherapy with a brief review of literature.