Assuntos
Neoplasias Hepáticas , Mesotelioma Maligno , Mesotelioma , Humanos , Feminino , Idoso , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , Mesotelioma Maligno/diagnóstico , Mesotelioma Maligno/patologia , Mesotelioma/diagnóstico , Mesotelioma/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologiaRESUMO
Ranked high in worldwide growing health issues, pleural diseases affect approximately one million people globally per year and are often correlated with a poor prognosis. Among these pleural diseases, malignant pleural mesothelioma (PM), a neoplastic disease mainly due to asbestos exposure, still remains a diagnostic challenge. Timely diagnosis is imperative to define the most suitable therapeutic approach for the patient, but the choice of diagnostic modalities depends on operator experience and local facilities while bearing in mind the yield of each diagnostic procedure. Since the analysis of pleural fluid cytology is not sufficient in differentiating historical features in PM, histopathological and morphological features obtained via tissue biopsies are fundamental. The quality of biopsy samples is crucial and often requires highly qualified expertise. Since adequate tissue biopsy is essential, medical or video-assisted thoracoscopy (MT or VATS) is proposed as the most suitable approach, with the former being a physician-led procedure. Indeed, MT is the diagnostic gold standard for malignant pleural pathologies. Moreover, this medical or surgical approach can allow diagnostic and therapeutic procedures: it provides the possibility of video-assisted biopsies, the drainage of high volumes of pleural fluid and the administration of sterile calibrated talcum powder under visual control in order to achieve pleurodesis, placement of indwelling pleural catheters if required and in a near future potential intrapleural therapy. In this context, dedicated diagnostic pathways remain a crucial need, especially to quickly and properly diagnose PM. Lastly, the interdisciplinary approach and multidisciplinary collaboration should always be implemented in order to direct the patient to the best customised diagnostic and therapeutic pathway. At the present time, the diagnosis of PM remains an unsolved problem despite MDT (multidisciplinary team) meetings, mainly because of the lack of standardised diagnostic work-up. This review aims to provide an overview of diagnostic procedures in order to propose a clear strategy.
Assuntos
Mesotelioma Maligno , Neoplasias Pleurais , Humanos , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/terapia , Mesotelioma Maligno/diagnóstico , Mesotelioma Maligno/terapia , Mesotelioma Maligno/patologia , Mesotelioma/diagnóstico , Mesotelioma/terapia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Biópsia/métodos , Cirurgia Torácica Vídeoassistida/métodosRESUMO
Objective: This study aimed to develop nomogram predicting overall survival (OS) of patients with peritoneal mesothelioma (PeM) using data from Surveillance, Epidemiology, and End Results (SEER) database and a Chinese institution. Methods: 1,177 PeM patients from the SEER database were randomized into training and internal validation cohorts at a 7:3 ratio. An external validation cohort consisting of 109 patients was enrolled from a Chinese institution. Nomogram was constructed based on variables identified through multivariate Cox regression analysis and evaluated by consistency indices (C-index), calibration plots, and receiver operating characteristic (ROC) curves. Patients were stratified into different risk categories, and Kaplan-Meier survival analysis was used to assess OS differences among these groups. Results: The nomogram, incorporating age, gender, histological type, T stage, M stage, and surgical status, demonstrated strong predictive capability with C-index values of 0.669 for the training cohort, 0.668 for the internal validation cohort, and 0.646 for the external validation cohort. The nomogram effectively stratified patients into high-risk and low-risk groups, with the high-risk group exhibiting significantly poorer OS (P < 0.05). Multivariate analysis confirmed gender, age, surgical intervention, and M stage as independent prognostic factors (P < 0.05). Specifically, male gender, older age, and unspecified M stage were linked to worse outcomes, while surgical intervention was associated with improved survival. Conclusion: The nomogram provide a reliable tool for predicting the survival in PeM patients, facilitating more informed treatment decisions. Key independent prognostic factors include gender, age, surgical intervention, and M stage.
Assuntos
Nomogramas , Neoplasias Peritoneais , Programa de SEER , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/epidemiologia , Neoplasias Peritoneais/patologia , China/epidemiologia , Idoso , Prognóstico , Adulto , Estudos de Coortes , Mesotelioma/mortalidade , Mesotelioma/patologia , Mesotelioma/epidemiologia , Mesotelioma/diagnóstico , Taxa de Sobrevida , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/diagnóstico , População do Leste AsiáticoAssuntos
Erros de Diagnóstico , Mesotelioma Maligno , Mesotelioma , Hidrocele Testicular , Neoplasias Testiculares , Humanos , Masculino , Hidrocele Testicular/diagnóstico , Hidrocele Testicular/cirurgia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Mesotelioma/diagnóstico , Mesotelioma Maligno/diagnóstico , Mesotelioma Maligno/patologia , Neoplasias Pulmonares/diagnóstico , Cordão Espermático , Orquiectomia , Pessoa de Meia-IdadeRESUMO
Mesothelioma of the testicular vagina is a rare malignant tumour, most often discovered by chance. The rarity of this type of tumour has not led to the development of specific guidelines. Median survival is estimated at 30 months. The lack of data and official recommendations makes surgical and medical management and follow-up difficult. Men who have not undergone radical orchiectomy die very rapidly after diagnosis. The remission rate at 1 year post-orchidectomy is 47 %, the recurrence rate at 1 year is 53 % and 92 % of relapses occur within 5 years post-operatively. The treatment option of hemiscrotectomy in the first instance has rarely been used; a second-look resection with negative margins may be proposed. The usefulness of adjuvant chemotherapy and/or radiotherapy has not been clearly demonstrated. Local recurrence is accompanied by metastasis in 85 % of cases. In the case of metastatic cancer (15 %), the retro-peritoneal, inguinal and iliac lymph nodes may be invaded. Follow-up by injected thoraco-abdomino-pelvic CT scan is recommended every 3 months for 2 years, then once a year for 3 years, for a total of 5 years of close follow-up. The long-term recurrence rate is 3 %.
Le mésothéliome de la vaginale testiculaire est une tumeur maligne rare et souvent de découverte fortuite. Sa rareté d'apparition n'a pas permis de développer des recommandations spécifiques. La survie médiane est estimée à 30 mois. Le manque de recommandations officielles rend sa prise en charge chirurgicale, médicale et son suivi difficiles. Les hommes n'ayant pas bénéficié d'orchidectomie radicale décèdent très rapidement après le diagnostic. Le taux de rémission à 1 an post-orchidectomie est de 47 %, le taux de récurrence à 1 an est de 53 % et 92 % des rechutes se font endéans les 5 ans post-opératoires. L'option thérapeutique par hémi-scrotectomie en première intention a rarement été pratiquée, une résection de «second look¼ en marges saines peut être proposée. L'utilité d'une chimiothérapie et/ou d'une radiothérapie adjuvante n'a pas été clairement démontrée. Une rechute locale est accompagnée de métastases dans 85 % des cas. En cas de cancer d'emblée métastatique (15 %), les relais ganglionnaires rétro-péritonéaux, inguinaux et iliaques peuvent être envahis. Un suivi par scanner thoraco-abdomino-pelvien injecté est recommandé tous les 3 mois pendant 2 ans, puis 1 fois par an pendant 3 ans pour un total de 5 ans. Le taux de récidive au long cours est de 3 %.
Assuntos
Neoplasias Testiculares , Neoplasias Vaginais , Humanos , Masculino , Neoplasias Testiculares/terapia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Neoplasias Vaginais/terapia , Neoplasias Vaginais/diagnóstico , Neoplasias Vaginais/patologia , Mesotelioma/terapia , Mesotelioma/diagnóstico , Mesotelioma/patologia , Mesotelioma Maligno/terapia , Mesotelioma Maligno/diagnóstico , Mesotelioma Maligno/patologia , Orquiectomia , Feminino , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologiaRESUMO
Diffuse mesotheliomas are characterized by recurrent genomic alterations involving tumor suppressors and epigenetic regulators such as BAP1, CDKN2A, MTAP, and NF2. Depending on the differential diagnosis as informed by histologic assessment, one can apply the appropriate immunohistochemical and/or molecular panels to reach the correct pathologic diagnosis, sometimes even in cases with limited tissues. Biomarkers aid in the diagnosis of mesothelioma in the following scenarios: 1) For a tumor that is overtly malignant, how can one distinguish mesothelioma from other tumors? 2) For a mesothelial proliferation, how can one distinguish mesothelioma from a reactive process? To distinguish mesotheliomas from carcinomas, at least two positive and two negative markers are currently recommended. To distinguish sarcomatoid mesothelioma from pleomorphic carcinoma, even more markers-and sometimes molecular testing-are needed. To distinguish mesothelioma from reactive mesothelial conditions, useful immunohistochemical biomarkers include BAP1, MTAP, and merlin, which serve as surrogates for the corresponding gene mutation status. In patients with unusual clinical history, for tumors with a peculiar microscopic appearance, and/or in cases with an equivocal immunophenotypic profile, molecular testing can help to exclude mimics and to confirm the pathologic diagnosis.
Assuntos
Biomarcadores Tumorais , Mesotelioma , Humanos , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Mesotelioma/diagnóstico , Mesotelioma/genética , Mesotelioma/patologia , Mesotelioma/metabolismo , Diagnóstico Diferencial , Patologia Molecular/métodos , Imuno-Histoquímica , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo , Ubiquitina Tiolesterase/genética , Ubiquitina Tiolesterase/metabolismoRESUMO
INTRODUCTION: Questions concerning under-reporting of occupational diseases (OD) linked to asbestos exposure are regularly voiced in France. Monitoring of the French multicenter Asbestos-Related Disease Cohort (ARDCO), which ensures post-occupational medical surveillance of subjects having been exposed to asbestos, provides information on (1) the medico-legal steps taken following screening by computed tomography (CT) for benign thoracic diseases, and (2) recognition of OD as a causal factor in malignant diseases. METHODS: OD recognition - and possible compensation - was analyzed in July 2021 among 13,289 volunteers in the cohort recruited between 2003 and 2005. RESULTS: Fifteen percent of the subjects in the cohort were found to have at least one recognized asbestos-related OD (78.2% benign pleural disease, 10.3% asbestosis, 14.2% lung cancer, and 6.0% mesothelioma). Only 58% of pleural plaques reported by the radiologist who performed the CT resulted in their recognition as ODs. On a parallel track, 88.7% of the mesotheliomas identified based on French National health insurance data and 46.9% of lung cancers were recognized as ODs. CONCLUSIONS: This study confirms the feasibility of a system designed to facilitate recognition, leading to possible compensation, of asbestos-related occupational diseases. The system could be improved by better training of the medical actors involved.
Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Doenças Profissionais , Exposição Ocupacional , Indenização aos Trabalhadores , Humanos , França/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Masculino , Pessoa de Meia-Idade , Feminino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Idoso , Asbestose/epidemiologia , Asbestose/diagnóstico , Estudos de Coortes , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiologia , Indenização aos Trabalhadores/estatística & dados numéricos , Amianto/efeitos adversos , Adulto , Idoso de 80 Anos ou mais , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Mesotelioma/epidemiologia , Mesotelioma/diagnóstico , Mesotelioma/etiologiaRESUMO
BACKGROUND Malignant peritoneal mesothelioma (MPM) is a rare, lethal tumor of serous membranes. The most common factor reported in association with MPM is asbestos exposure, while viral infections, genetic predisposition, paraneoplastic syndrome, and altered immunity have been described as well. The diagnosis can be challenging among those with lower tumor burden as well as nonspecific symptoms, and it is not unusual to discover the diagnosis incidentally. CASE REPORT A middle-aged woman with decompensated cirrhosis underwent extensive pre-transplant workup, showing no evidence of malignancy. She had a personal history of asbestos exposure and family history of MPM in the extended family. During transplant surgery, a few peritoneal nodules were noted, leading to termination of the procedure. Pathological analysis confirmed malignant MPM. A multidisciplinary discussion led to following a conservative treatment approach without any intervention, due to higher risk of worsening hepatic decompensation associated with peritonectomy and intraperitoneal chemotherapy. The patient's hepatic decompensation resolved 6 months after the aborted liver transplant operation. Since the diagnosis of MPM, positron emission tomography scans have shown no recurrence of MPM for 3 consecutive years. CONCLUSIONS This is the first case of MPM diagnosed incidentally during a liver transplantation surgery. This case highlights the challenges in the diagnosis and management of MPM in a patient with decompensated liver disease. A multidisciplinary approach and following a consensus decision led to prolonged survival in the described patient.
Assuntos
Achados Incidentais , Transplante de Fígado , Mesotelioma Maligno , Neoplasias Peritoneais , Humanos , Feminino , Neoplasias Peritoneais/diagnóstico , Pessoa de Meia-Idade , Mesotelioma Maligno/diagnóstico , Mesotelioma/diagnóstico , Neoplasias Pulmonares/diagnósticoRESUMO
Pleural mesothelioma (PM) is a highly aggressive tumor that is caused by asbestos exposure and lacks effective therapeutic regimens. Current procedures for PM diagnosis are invasive and can take a long time to reach a definitive result. Small extracellular vesicles (sEVs) have been identified as important communicators between tumor cells and their microenvironment via their cargo including circular RNAs (circRNAs). CircRNAs are thermodynamically stable, highly conserved, and have been found to be dysregulated in cancer. This study aimed to identify potential biomarkers for PM diagnosis by investigating the expression of specific circRNA gene pattern (hsa_circ_0007386) in cells and sEVs using digital polymerase chain reaction (dPCR). For this reason, 5 PM, 14 non-PM, and one normal mesothelial cell line were cultured. The sEV was isolated from the cells using the gold standard ultracentrifuge method. The RNA was extracted from both cells and sEVs, cDNA was synthesized, and dPCR was run. Results showed that hsa_circ_0007386 was significantly overexpressed in PM cell lines and sEVs compared to non-PM and normal mesothelial cell lines (p < 0.0001). The upregulation of hsa_circ_0007386 in PM highlights its potential as a diagnostic biomarker. This study underscores the importance and potential of circRNAs and sEVs as cancer diagnostic tools.
Assuntos
Biomarcadores Tumorais , Vesículas Extracelulares , Mesotelioma , RNA Circular , Humanos , RNA Circular/genética , RNA Circular/metabolismo , Vesículas Extracelulares/metabolismo , Vesículas Extracelulares/genética , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Mesotelioma/genética , Mesotelioma/diagnóstico , Linhagem Celular Tumoral , Neoplasias Pleurais/genética , Neoplasias Pleurais/diagnóstico , Regulação Neoplásica da Expressão Gênica , Mesotelioma Maligno/genética , Mesotelioma Maligno/diagnósticoRESUMO
We developed a composite symptom score (CSS) representing disease-related symptom burden over time in patients with malignant pleural mesothelioma (MPM). Longitudinal data were collected from an open-label Phase IIB study in which 239 patients completed the validated MD Anderson Symptom Inventory for MPM (MDASI-MPM). A blinded, independent review committee of external patient-reported outcomes experts advised on MDASI-MPM symptoms to include in the CSS. Through iterative analyses of potential symptom-item combinations, 5 MPM symptoms (pain, fatigue, shortness of breath, muscle weakness, coughing) were selected. The CSS correlated strongly with the full MDASI-MPM symptom set (0.92-0.94) and the Lung Cancer Symptom Scale-Mesothelioma (0.79-0.87) at each co-administration of the scales. The CSS also had good sensitivity to worsening disease and global quality-of-life ratings. The MDASI-MPM CSS can be used as an outcome in MPM clinical trials, including in responder analyses and at the individual patient level. It is brief enough to administer frequently, including electronically, to better capture symptom trajectories during and after a trial and in clinical practice. As a single score, the CSS addresses multiplicity issues that can arise when several symptoms increase due to worsening disease. Our process can be adapted to produce a CSS for other advanced-cancer trials.
Assuntos
Mesotelioma Maligno , Neoplasias Pleurais , Qualidade de Vida , Humanos , Mesotelioma Maligno/tratamento farmacológico , Mesotelioma Maligno/patologia , Mesotelioma Maligno/diagnóstico , Masculino , Feminino , Neoplasias Pleurais/diagnóstico , Idoso , Pessoa de Meia-Idade , Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Medidas de Resultados Relatados pelo Paciente , Fadiga , Avaliação de Sintomas , Estudos Longitudinais , Índice de Gravidade de Doença , Carga de SintomasRESUMO
Wolffian tumor and its nosologic relative, the recently defined STK11 adnexal tumor are rare neoplasms thought to arise from mesonephric remnants. These tumors typically arise in the broad ligament, fallopian tube, and ovarian hilum and although most are associated with a good prognosis, up to 50% of STK11 adnexal tumors demonstrate aggressive clinical behavior. The chief differential diagnoses include endometrioid adenocarcinoma and sex cord stromal tumors. However, the morphologic and immunohistochemical features of these tumors exhibit considerable overlap with peritoneal mesothelioma. To fully characterize their immunophenotypic signature, we examined a total of 21 cases (18 Wolffian and 3 STK11 adnexal tumors) with standard markers used in the diagnosis of mesothelioma. Morphologic and immunohistochemical (IHC) features were reviewed and additional IHC performed for cases with available material. Patient age ranged from 25 to 73 (mean: 51) years. Sites included adnexa/broad ligament (6, 28%), paratubal (5, 24%), ovary/paraovarian (5, 24%), tubal (intraluminal) (2, 9.5%), pelvis (2, 9.5%), and liver (1, 5%). The mean tumor size was 9.3 cm (range: 0.2 to 22 cm). The histomorphology in most cases (14/21, 66%) consisted of tubular to solid sheets of neoplastic cells lined by columnar to cuboidal cells containing uniform round to oval nuclei. Compressed tubules with slit-like lumens and sieve-like pattern were also seen in at least 7 (33%) cases. Three cases demonstrated interanastomosing cords and trabeculae of epithelioid cells with cribriform and microacinar patterns growing within prominent myxoid stroma as described in STK11 adnexal tumors. In the cases with available IHC for 3 mesothelial markers (calretinin, WT1, D2-40), 55.5% (5 of 9) showed reactivity with all 3 markers. In cases with at least 2 available mesothelial markers, 69% (11/16) were positive for 2 markers (mostly calretinin and WT1). Claudin-4, MOC31, and BER-EP4 were negative in most cases tested (78% [7/9], 71.4% [5/7], and 100% [6/6], respectively). Given the resemblance to mesothelioma, there was initial strong consideration and/or actual misdiagnosis of mesothelioma in 3 cases (14%). In summary, the morphologic and immunohistochemical features of Wolffian tumor and its recently defined relative, STK11 adnexal tumor, can lead to misdiagnosis of mesothelioma, particularly when encountered in the disseminated or metastatic setting. Wolffian tumor and STK11 adnexal tumor should be considered in the differential diagnosis of all pelvic and peritoneal mesotheliomas.
Assuntos
Biomarcadores Tumorais , Imuno-Histoquímica , Mesotelioma , Neoplasias Peritoneais , Humanos , Feminino , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/química , Neoplasias Peritoneais/diagnóstico , Biomarcadores Tumorais/análise , Diagnóstico Diferencial , Pessoa de Meia-Idade , Idoso , Adulto , Mesotelioma/patologia , Mesotelioma/diagnóstico , Mesotelioma/química , Valor Preditivo dos Testes , Quinases Proteína-Quinases Ativadas por AMP , Adenoma , Doenças dos AnexosRESUMO
Imaging continues to gain a greater role in the assessment and clinical management of patients with mesothelioma. This communication summarizes the oral presentations from the imaging session at the 2023 International Conference of the International Mesothelioma Interest Group (iMig), which was held in Lille, France from June 26 to 28, 2023. Topics at this session included an overview of best practices for clinical imaging of mesothelioma as reported by an iMig consensus panel, emerging imaging techniques for surgical planning, radiologic assessment of malignant pleural effusion, a radiomics-based transfer learning model to predict patient response to treatment, automated assessment of early contrast enhancement, and tumor thickness for response assessment in peritoneal mesothelioma.
Assuntos
Mesotelioma , Neoplasias Pleurais , Humanos , Mesotelioma/diagnóstico , Mesotelioma/diagnóstico por imagem , Mesotelioma/patologia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/patologia , Mesotelioma Maligno/patologia , Mesotelioma Maligno/diagnóstico , Mesotelioma Maligno/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologiaRESUMO
BACKGROUND Malignant peritoneal mesothelioma is a rare disease with a poor prognosis that often presents with vague symptoms and inconclusive laboratory test results. Causes include industrial pollutants, primarily asbestos, and certain genetic mutations, such as BAP1. Due to the nonspecific symptoms, it is often incidentally diagnosed during or after other surgical procedures. CASE REPORT A 35-year-old healthy woman underwent an uncomplicated laparoscopic left salpingo-oophorectomy for a symptomatic large ovarian mature cystic teratoma. She subsequently presented with late-onset postoperative fever, leukocytosis, and multiple intra-abdominal masses. Following an exploratory laparotomy, extensive infectious disease evaluation, and multiple biopsies requiring interdisciplinary collaboration, malignant peritoneal mesothelioma was diagnosed by positive histologic staining of an omental biopsy for D2-40 and CK5/6. This first specimen was positive for BAP1, with the second, a liver biopsy, testing negative for BAP1. The tumor cell testing was also notable for mutations in NF2, MLL2, and ARID1A, and the hereditary cancer genetic testing was overall unremarkable. Her disease progressed rapidly, and she died 6 months after her initial procedure. CONCLUSIONS This case of rapidly developing malignant peritoneal mesothelioma following surgical management of an ovarian mature teratoma highlights the complexity in diagnosing a rare disease that presents with nonspecific symptoms in an otherwise young and healthy woman. The rapid disease course was likely accelerated by expansive intraperitoneal spread and multiple somatic oncogenic mutations in BAP1, NF2, MLL2, and ARID1A. Gynecologists should keep a broad differential for postoperative complications, as occult malignancies can present with symptoms that mimic postoperative complications.
Assuntos
Mesotelioma Maligno , Neoplasias Ovarianas , Neoplasias Peritoneais , Complicações Pós-Operatórias , Humanos , Feminino , Adulto , Neoplasias Peritoneais/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia , Mesotelioma Maligno/diagnóstico , Evolução Fatal , Diagnóstico Diferencial , Progressão da Doença , Teratoma/diagnóstico , Teratoma/cirurgia , Salpingo-Ooforectomia , Mesotelioma/diagnósticoRESUMO
Spindle cell lesions of the pleura and pericardium are rare. Distinction from sarcomatoid mesothelioma, which has a range of morphologic patterns, can be difficult, but accurate diagnosis matters. This article provides practical guidance for the diagnosis of pleural spindle cell neoplasms, focusing on primary lesions.
Assuntos
Pericárdio , Neoplasias Pleurais , Humanos , Pericárdio/patologia , Neoplasias Pleurais/patologia , Neoplasias Pleurais/diagnóstico , Diagnóstico Diferencial , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/diagnóstico , Mesotelioma/patologia , Mesotelioma/diagnóstico , Sarcoma/patologia , Sarcoma/diagnóstico , Biomarcadores Tumorais/análise , Pleura/patologiaRESUMO
17-ß-estradiol, involved in mesothelioma pathogenesis, and its precursors were explored as potential biomarkers for the early diagnosis of mesothelioma. Using enzyme-linked immunosorbent assay(ELISA) for 17-ß-estradiol and ultra-high performance liquid chromatography/tandem mass spectrometry(UHPLC-MS/MS) for 19 17-ß-estradiol precursors, a comprehensive analysis of 20steroid hormones was conducted in the serum of mesothelioma patients(n=67), asbestos-exposed healthy subjects(n=39), and non-asbestos-exposed healthy subjects(n=35). Bioinformatics analysis explored three potential serum biomarkers: 17-ß-estradiol, DHEA-S, and androstenedione. The results revealed significant differences in 17-ß-estradiol levels between mesothelioma patients and both non-asbestos-exposed and asbestos-exposed healthy subjects. No significant variations in serum 17-ß-estradiol levels were observed among mesothelioma patients at different stages, suggesting its potential as an early diagnostic marker. 17-ß-estradiol levels were similar in mesothelioma patients with environmental and occupational asbestos exposure, while males with occupational asbestos exposure exhibited significantly higher levels of 17-ß-estradiol compared to females. Significant reduction in androstenedione and an increase in DHEA-S were observed in asbestos-exposed individuals compared to non-asbestos-exposed individuals. The analysis of DHEA-S-androstenedione-17-ß-estradiol signature score showed an increase in asbestos-exposed individuals and mesothelioma patients compared to non-asbestos-exposed individuals, and this score effectively distinguished between the groups. The Cancer Genome Atlas data was utilized to analyze the expression of 5-α-reductase1 and hydroxysteroid-17ß-dehydrogenase2 genes. The findings indicated that mesothelioma patients with elevated gene values for 5-α-reductase1 and hydroxysteroid-17ß-dehydrogenase2 have a worse or better prognosis on overall survival, respectively. In conclusion, this study suggests 17-ß-estradiol, DHEA-S, and androstenedione as biomarkers for mesothelioma risk and early diagnosis of mesothelioma in asbestos-exposed individuals, aiding timely intervention and improved care.
Assuntos
Androstenodiona , Amianto , Biomarcadores Tumorais , Estradiol , Neoplasias Pulmonares , Mesotelioma Maligno , Exposição Ocupacional , Humanos , Estradiol/sangue , Masculino , Biomarcadores Tumorais/sangue , Androstenodiona/sangue , Amianto/toxicidade , Amianto/efeitos adversos , Feminino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Idoso , Mesotelioma Maligno/sangue , Mesotelioma Maligno/diagnóstico , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/diagnóstico , Mesotelioma/sangue , Mesotelioma/diagnóstico , Mesotelioma/induzido quimicamente , Neoplasias Pleurais/sangue , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/induzido quimicamente , Desidroepiandrosterona/sangue , Estudos de Casos e Controles , Detecção Precoce de Câncer/métodosRESUMO
OBJECTIVE: To review the pathological diagnosis of possible cases and/or hidden cases of malignant mesothelioma (MM) between 2000 and 2012 using the Hospital-Based Cancer Registry database in the state of São Paulo, Brazil. METHODS: Possible cases were retrieved by assessing the database. Inclusion criteria were being older than 30 years of age and having ICD-O-3 topography and morphology codes related to MM. A board of expert pathologists reviewed the pathology reports and requested paraffin blocks in cases that demanded revision. After staining with calretinin, D2-40, WT-1 (as positive MM markers) and Ber-EP4 and MOC31 (as negative MM markers), cases were divided and studied independently by a pair of pathologists to confirm or discard the diagnosis of MM. RESULTS: Our sample comprised 482 cases from 25 hospitals, and 130 needed further histological revision. We received 73 paraffin blocks with adequate material. After board analysis, there were 9 cases with a definitive diagnosis of MM, improving the diagnostic rate in 12%. Two cases of previously diagnosed MM were discarded by review. CONCLUSIONS: Our results confirm that part of MM underdiagnosis and underreporting in Brazil is due to incomplete or mistaken pathological diagnosis.
Assuntos
Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Sistema de Registros , Humanos , Brasil/epidemiologia , Mesotelioma/patologia , Mesotelioma/epidemiologia , Mesotelioma/diagnóstico , Mesotelioma Maligno/patologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/epidemiologia , Adulto , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Neoplasias Pleurais/patologia , Neoplasias Pleurais/epidemiologia , Neoplasias Pleurais/diagnósticoRESUMO
Paratesticular mesothelioma is a very rare tumour, accounting for 0.3 to 1.4% of all mesotheliomas. Mesothelioma arising from the spermatic cord is extremely rare with only a few cases reported in the literature. We report a case of spermatic cord mesothelioma in a 70-year-old man who presented with a right inguinal mass and pain.