Post-irradiation pericardial malignant mesothelioma with deletion of p16: a case report

Abstract

Malignant mesotheliomas are rather uncommon neoplasms associated primarily with asbestos exposure; however, they may also arise as second primary malignancies after radiation therapy, with a latency period of 15–25 years. Numerous studies have reported an association between pleural malignant mesothelioma and chest radiation performed for other malignancies; on the other hand, post-irradiation mesotheliomas of the pericardium have been reported in only a few published cases to date, and no homozygous deletion of 9p21 has been described in such cases. We report the case of a 48-year-old man with a history of Hodgkin's lymphoma and no prior asbestos exposure who developed pericardial malignant epithelioid mesothelioma. We further discuss the cytologic, histologic, immunophenotypic, and fluorescence in situ hybridization findings in this case. To our knowledge, this is the first well-documented case of post-radiation pericardial malignant mesothelioma showing homozygous deletion of 9p21. Homozygous deletion of 9p21, the locus harboring the p16 gene, is present in post-irradiation pericardial malignant mesothelioma.

Sudden cardiac death due to primary malignant pericardial mesothelioma: Brief report and literature review

“…Various risk factors have been reported for PMPM including exposure to asbestos [13,14], post-irradiation [15], and speculative infection with Simian virus 40 [16].…”

Pericardial Mesotheliomas

“…12,13 A history of prior radiation treatment has been reported in patients with PM, particularly Hodgkin lymphoma and breast cancer, with latency periods ranging from 14 to 27. 12,[14][15][16][17] Although 17% of PM analyzed from the SEER database had a prior history of cancer, no information regarding radiation treatment was provided. 1 Nevertheless, well-rounded epidemiological and analytical case-control studies are needed to understand the risk factors and pathogenesis of PM, which are limited by their low incidence.…”

“…Interestingly, Fukasawa et al10 reported a patient with PM with loss of BAP-1 by immunohistochemistry, who was alive after 3 years of follow-up, in concordance with the longer survival observed in pleural mesotheliomas with BAP-1 mutations. Two reports alluded to the evaluation of BAP-1 in PM, which is commonly lost in pleural mesotheliomas; of these, 2 cases had a deletion of BAP-1 , as demonstrated by fluorescence in situ hybridization (FISH) 12,13…”

“…A history of prior radiation treatment has been reported in patients with PM, particularly Hodgkin lymphoma and breast cancer, with latency periods ranging from 14 to 27 12,14–17. Although 17% of PM analyzed from the SEER database had a prior history of cancer, no information regarding radiation treatment was provided 1…”

“…Two reports alluded to the evaluation of BAP-1 in PM, which is commonly lost in pleural mesotheliomas; of these, 2 cases had a deletion of BAP-1, as demonstrated by fluorescence in situ hybridization (FISH). 12,13 A history of prior radiation treatment has been reported in patients with PM, particularly Hodgkin lymphoma and breast cancer, with latency periods ranging from 14 to 27. 12,[14][15][16][17] Although 17% of PM analyzed from the SEER database had a prior history of cancer, no information regarding radiation treatment was provided.…”