Malignant Mesothelioma: King Faisal Specialist Hospital and Research Centre Experience

Khan, Javed; Døssing, Martin; Curley, Winifred H.; Akhtar, Mohammed; Ma, Ali

doi:10.5144/0256-4947.1992.47

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…Colorectal cancer is the third most common cancer affecting both genders and the 5th leading cause of cancer related deaths worldwide ( 6 ). Malignant mesothelioma on the other hand is a rare disease with approximately 3,300 new cases of malignant mesotheliomas diagnosed every year in the USA ( 7 ). The incidence of mesothelioma in Kingdom of Saudi Arabia is still unclear, which is attributed to the rarity of the disease and under-recognition of cases.…”

Section: Discussionmentioning

confidence: 99%

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Synchronous Malignant Peritoneal Mesothelioma and Sigmoid Adenocarcinoma: a Challenging Clinical Entity

Alratrout,

Boumarah,

Alghusnah

et al. 2023

Med Arch

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Background: Malignant peritoneal mesothelioma (MPM) represents a rare clinical entity. The synchronous existence of MPM with other malignancies as colonic adenocarcinoma have been rarely reported. Its diagnosis and management are challenging given its complexity and rarity. Objective: Herein, we report a case of epithelioid subtype of MPM occurring synchronously with sigmoid colonic adenocarcinoma, along with review of the literature. Case presentation: An elderly female patient was referred as case of rectosigmoid mass. She reported history of abdominal pain, per-rectal bleeding, anorexia, and significant weight loss. Her computed-tomography scan of the abdomen revealed a fistulizing sigmoid mass and multiple enlarged lymphnodes with omental nodulation. The colonoscopy revealed a large fungating mass and the endoscopic biopsies were reported as colonic adenocarcinoma. The patient was scheduled laparoscopic low anterior resection. However, the diagnostic laparoscopy revealed several nodules disseminated all over the peritoneum, suggestive of peritoneal mesothelioma. Therefore, the decision was changed to create transverse colostomy after examination obtaining multiple biopsies from the omental and peritoneal nodules. The histopathological revealed MPM and the final diagnosis was sigmoid adenocarcinoma with synchronous MPM. The patient was started on palliative chemotherapy (capecitabine) without active management of MPM because of her general condition. She was followed up with a good clinical course. Conclusion: MPM is an overlooked entity with vague clinical presentation. Synchronous MPM with colorectal cancer is rare with only few published case reports. Its diagnosis is challenging, and its management should be tailored according to the patient. This case is the first reported case in Saudi Arabia and the Middle East.

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Section: Discussionmentioning

confidence: 99%

“…In King Faisal Specialist Hospital and Research Center, ten cases of malignant mesothelioma were reported as a single institution experience. In 2000, the first case of MPM in Saudi Arabia was reported in a case of exudative ascites that was found to be malignant peritoneal mesothelioma( 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

Synchronous Malignant Peritoneal Mesothelioma and Sigmoid Adenocarcinoma: a Challenging Clinical Entity

Alratrout,

Boumarah,

Alghusnah

et al. 2023

Med Arch

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confidence: 99%

Malignant Mesothelioma in Saudi Arabia

Hughes

1993

Ann Saudi Med

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Hospital and Research Centre experience" by Khan et al [1] and would like to address several points: Although I do not doubt the histological diagnosis of the ten cases described, the finding that only one case had established occupational exposure to asbestos is most likely explained by incomplete occupational and environmental histories. Most patients have had several occupations during their working lives and physicians tend only to record the last occupation. Retired people often give the most prestigious occupation when queried. It is also probable that the two Bedouins mentioned in the study had had several undisclosed occupations during their lives. In addition, the two housewives described in the study with mesothelioma, the occupations of their husbands are relevant but were not stated. Asbestos exposure has occurred when wives wash contaminated work clothing of their husbands.Thus, the occupations stated in this study may be very misleading, this being particularly relevant when one considers the long dormant period (at times as long as 40 years) between the exposure to asbestos and the development of mesothelioma.There was no report in the study denoting whether sputum or lung histological searches for asbestos bodies were performed which could have also established exposure to asbestos.To my knowledge, asbestos is not presently being mined in Saudi Arabia but there have been vast amounts of imported insulating materials etc., pipes and automobile brake shoes; many of which contain asbestos. Demolition sites and junk yards are the most likely places for asbestos exposure.Mesothelioma is a rare tumor and asbestos is the most common known cause. Although it is tempting to postulate other causes of mesothelioma, I believe the most likely cause of mesothelioma in the cases described in this study was asbestos exposure. J.C. Hughes, MSC, DRCOG, DCH, MRCGP, AFOM Occupational Physician and Medical Officer Saudi

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Malignant Mesothelioma: King Faisal Specialist Hospital and Research Centre Experience

Cited by 2 publications

References 20 publications

Synchronous Malignant Peritoneal Mesothelioma and Sigmoid Adenocarcinoma: a Challenging Clinical Entity

Synchronous Malignant Peritoneal Mesothelioma and Sigmoid Adenocarcinoma: a Challenging Clinical Entity

Malignant Mesothelioma in Saudi Arabia

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