Malignant deciduoid mesothelioma of the pleura: report of two cases with long survival

Abstract

This deciduoid mesothelioma histological subtype does not appear to represent an unfavourable prognostic category.

Deciduoid mesothelioma: report of 21 cases with review of the literature

“…Subsequent investigations, however, have demonstrated that deciduoid mesotheliomas are not restricted to the peritoneum of young women, but can also arise in the pleura of older men and women who have a history of asbestos exposure, 4,5 and these tumors may also have a less aggressive clinical course than was first reported. 14 Of the 64 cases of deciduoid mesothelioma, including the 43 reported in the literature (Table 1) and the 21 in the present series (Table 3), 34 occurred in males who ranged in age from 13 to 78 years (mean, 62 years) and 30 in females who ranged in age from 13 to 71 years (mean, 44 years). In 39 cases, the tumor originated in the pleura, 22 in the peritoneum, 1 in the pericardium, and 2 in the paratesticular region.…”

“…8,9,23,24 Mitotic activity has been documented as being variable and, although some reports have mentioned that the tumor had high mitotic activity and the presence of atypical mitoses, [2][3][4][5]8 others have indicated that only rare or few mitoses were present. 11,13,14,21,24 In addition to the previously mentioned morphological features, some of the published reports have included other findings that, although uncommon, can also occur in deciduoid mesotheliomas. These include the presence of focal areas in which the cells present foamy, 18 vacuolated 10,11 or clear cytoplasm, 15,19 prominent intracytoplasmic lumina, 3,5,15 focal rhabdoid changes, 7,19 and mucinous or myxoid stroma.…”

“…Although in early studies it was emphasized that this mesothelioma variant is characterized by an aggressive clinical behavior, 1-3 some subsequent investigations have indicated that they do not represent a category of tumors with an unfavorable prognosis nor do they behave in a manner that is clinically different from other more conventional epithelioid mesotheliomas. 14,15 It should be noted that detailed information regarding the histological features of these tumors was provided in relatively few of the reported cases of deciduoid mesothelioma for which follow-up information was available (Table 1). In the five reported cases in which it was indicated that the tumor had high mitotic activity (45 mitoses per 10 HPF), including the presence of atypical mitoses, the patients had a shorter survival (5-11 months, mean 8); 2,3,5 while in five of those cases in which it was stated that the mitotic figures were rare or uncommon (o3 per 10 HPF), two patients died of disease 17 and 30 months after diagnosis, respectively, 14 and three were alive at the time of publication 12, 20, and 32 months after diagnosis, respectively.…”

“…5 In these reports, however, it was demonstrated that mesotheliomas with deciduoid features can also originate in the pleura, occur in elderly men, and be associated with asbestos exposure. Since then, several other cases, mostly individual case reports, have been published [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] (Table 1). Although patient survival in many of the published cases has been short and limited to a few months after diagnosis, thus suggesting that deciduoid mesotheliomas have an aggressive clinical course, patients with long survival …”

Granulocyte-colony stimulating factor- and interleukin 6-producing diffuse deciduoid peritoneal mesothelioma

“…Deciduoid mesothelioma is distinguished from other tumors by positive staining for cytokeratin, vimentin, calretinin, HMBE-1, EMA, CA125 and thrombomodulin and negative staining for CEA, HMB45 and myogenin. [17][18][19][20] Some cases showed rhabdoid changes in deciduoid mesothelioma. 9 The presence of intracytoplasmic glycogen and hyaluronic acid also are important evidences for diagnosis of mesothelioma.…”