Malignant deciduoid mesothelioma: a rare variant of epithelioid mesothelioma

Abstract

We describe a case of a deciduoid mesothelioma, a rare variant of epithelioid mesothelioma, which is associated with a very poor prognosis. A review of the relevant literature is also included. The patient was a man with probable asbestos exposure and presented with classic features of pleural malignancy. Diagnosis was reached with close correlation between clinical, radiological and pathological findings.

Is the Deciduoid Variant of Pleural Mesothelioma Significant?

“…We agree that deciduoid cytology needs to be distinguished from carcinomas, but we have recently come across a case of deciduoid pleural mesothelioma which was associated with a very poor response to chemotherapy and a very limited life span in a patient with, initially, excellent performance status. 3 Our literature review revealed that the deciduoid variant is associated with a very poor prognosis, with an approximate 1-year mortality of 68%. Nevertheless, we are well aware that there are no large-scale survival studies for deciduoid pleural mesothelioma because it is a rare entity.…”

“…Reviewing the image in the article, it seemed that this tumor has a high nuclear grade-this becoming increasingly established as an important poor prognostic indicator. [2][3][4][5] Indeed, in one case series involving 21 epithelioid mesotheliomas with deciduoid cytology, 6 the cases could be prognostically separated through their nuclear features. Furthermore, a recent metaanalysis noted that there was no obvious difference overall between epithelioid mesotheliomas with deciduoid cellular structure and those without.…”