Fatih AKTOZ, Elif Taşar KAPAKLI, Günel ZİYADOVA, Oğuzhan KURU, Alp USUBÜTÜN, Zafer Selçuk TUNCER

Over kanseri kliniğini taklit eden malign peritoneal mezotelyoma

Başlıca bulguları over kaynaklı kitle, asit ve CA 125 yüksekliği olduğu için over kanseri ön tanısı ile cerrahiye alınan 78 yaşındaki olgunun kesin tanısı ancak patoloji raporunun malign mezotelyoma olarak raporlanması üzerine konulabilmiştir. Öyküsünden yıllar önce yaşadığı yer nedeniyle asbeste maruz kaldığı düşünülen hastada kesin tanı ameliyat öncesi konulamamıştır. Over kanseri ile klinik tablo açısından benzerlikler gösterse de tedavileri ve sonuçları açısından aralarında farklılık bulunan bu malign peritoneal mezotelyoma olgusu ayırıcı tanıya yardımcı olması açısından sunulmuştur.

Malignant peritoneal mesothelioma mimicking ovarian cancer

A patient who had ovarian mass, ascites and elevated CA 125 levels was treated with presumptive diagnosis of ovarian cancer. After pathological examination, she was finally diagnosed as malign peritoneal mesothelioma. Although exposure to asbestos was considered, the diagnosis was not revealed before surgery. Despite similarity of clinical features, ovarian cancer and malign peritoneal mesothelioma have different treatment options and long-term outcomes. The aim of this case report is to describe the process of differential diagnosis between malign peritoneal mesothelioma and ovarian cancer.

Keywords:

Mesothelioma, ovarian cancer,

PDF

___

1. Boffetta P. Epidemiology of peritoneal mesothelioma: a review. Ann Oncol. 2007;18:985-90.
2. Bridda A, Padoan I, Mencarelli R, Frego M. Peritoneal mesothelioma: a review. Med Gen Med. 2007;9:32.
3. Sugarbaker PH, Turaga KK, Alexander HR, Jr., Deraco M, Hesdorffer M. Management of malignant peritoneal mesothelioma using cytoreductive surgery and perioperative chemotherapy. J Oncol Pract. 2016;12:928-35.
4. Grzankowski KS, Brightwell RM, Kasznica JM, Odusi KO. Malignant peritoneal mesothelioma without asbestos exposure: an ovarian cancer imitator. Gynecol Oncol Rep. 2015;11:10-2.
5. Selikoff IJ, Hammond EC, Seidman H. Latency of asbestos disease among insulation workers in the United States and Canada. Cancer. 1980;46:2736-40.
6. Carbone M, Emri S, Dogan AU, Steele I, Tuncer M, Pass HI et al. A mesothelioma epidemic in Cappadocia: scientific developments and unexpected social outcomes. Nat Rev Cancer. 2007;7:147-54.
7. Goldberg M, Luce D. The health impact of nonoccupational exposure to asbestos: what do we know? Eur J Cancer Prev. 2009;18:489-503.
8. Hasanoglu HC, Yildirim Z, Ermis H, Kilic T, Koksal N. Lung cancer and mesothelioma in towns with environmental exposure to asbestos in Eastern Anatolia. Int Arch Occup Environ Health. 2006;79:89-91.
9. Shivapurkar N, Wiethege T, Wistuba, II, Milchgrub S, Muller KM, Gazdar AF. Presence of simian virus 40 sequences in malignant pleural, peritoneal and noninvasive mesotheliomas. Int J Cancer. 2000;85:743-5.
10. Andersson M, Wallin H, Jonsson M, Nielsen LL, Visfeldt J, Vyberg M et al. Lung carcinoma and malignant mesothelioma in patients exposed to Thorotrast: incidence, histology and p53 status. Int J Cancer. 1995;63:330-6.
11. Shivapurkar N, Wiethege T, Wistuba, II, Milchgrub S, Muller KM, Gazdar AF. Presence of simian virus 40 sequences in malignant pleural, peritoneal and noninvasive mesotheliomas. Int J Cancer. 2000;85:743-5.
12. Andersson M, Wallin H, Jonsson M, Nielsen LL, Visfeldt J, Vyberg M et al. Lung carcinoma and malignant mesothelioma in patients exposed to Thorotrast: incidence, histology and p53 status. Int J Cancer. 1995;63:330-6.
13. Baris I, Simonato L, Artvinli M, Pooley F, Saracci R, Skidmore J et al. Epidemiological and environmental evidence of the health effects of exposure to erionite fibres: a four-year study in the Cappadocian region of Turkey. Int J Cancer. 1987;39:10-7.
14. Alakus H, Yost SE, Woo B, French R, Lin GY, Jepsen K et al. BAP1 mutation is a frequent somatic event in peritoneal malignant mesothelioma. J Transl Med. 2015;13:122.
15. Kaya H, Sezgi C, Tanrikulu AC, Taylan M, Abakay O, Sen HS et al. Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma. Neoplasma. 2014;61:433-8.
16. Kebapci M, Vardareli E, Adapinar B, Acikalin M. CT findings and serum CA125 levels in malignant peritoneal mesothelioma: report of 11 new cases and review of the literature. Eur Radiol. 2003;13:2620-6.
17. Ros PR, Yuschok TJ, Buck JL, Shekitka KM, Kaude JV. Peritoneal mesothelioma: radiologic appearances correlated with histology. Acta Radiol. 1991;32:355-8.
18. Yan TD, Haveric N, Carmignani CP, Chang D, Sugarbaker PH. Abdominal computed tomography scans in the selection of patients with malignant peritoneal mesothelioma for comprehensive treatment with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Cancer. 2005;103:839-49
19. Benard F, Sterman D, Smith RJ, Kaiser LR, Albelda SM, Alavi A. Metabolic imaging of malignant pleural mesothelioma with fluorodeoxyglucose positron emission tomography. Chest. 1998;114:713-22.
20. Taskin S, Gumus Y, Kiremitci S, Kahraman K, Sertcelik A, Ortac F. Malignant peritoneal mesothelioma presented as peritoneal adenocarcinoma or primary ovarian cancer: case series and review of the clinical and immunohistochemical features. Int J Clin Exp Pathol. 2012;5:472-8.
21. Zhao L, Guo M, Sneige N, Gong Y. Value of PAX8 and WT1 immunostaining in confirming the ovarian origin of metastatic carcinoma in serous effusion specimens. Am J Clin Pathol. 2012;137:304-9.
22. Sugarbaker PH, Welch LS, Mohamed F, Glehen O. A review of peritoneal mesothelioma at the Washington Cancer Institute. Surg Oncol Clin N Am. 2003;12:605-21.
23. Sebbag G, Yan H, Shmookler BM, Chang D, Sugarbaker PH. Results of treatment of 33 patients with peritoneal mesothelioma. Br J Surg. 2000;87:1587-93.
24. Park BJ, Alexander HR, Libutti SK, Wu P, Royalty D, Kranda KC et al. Treatment of primary peritoneal mesothelioma by continuous hyperthermic peritoneal perfusion (CHPP). Ann Surg Oncol. 1999;6:582-90.