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G.N. Hillerdal
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P1.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 224)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.08-018 - Spontaneous Regression of Mesothelioma (ID 1046)
09:30 - 17:00 | Author(s): G.N. Hillerdal
- Abstract
Background:
Malignant pleural mesothelioma is a progressive disease with a poor prognosis. However, a few cases of spontanous regression has been reported in the literature. We here report another case.
Methods:
Not applicable
Results:
A 68-year old woman was referred to the clnic because of increasing dyspnoea and changes on her chest roentgenogram. She had never smoked and had worked in an office all life and denied all exposure to asbestos or other dangerous substances. CT scan revealed an irregular pleural thickening all around the right lung, in the interlobar fissure, and some enlarged mediastinal lymph nodes on the right side. Bronchsocpy, ultrasound biopsy of the pleura, and mediastinosccopy yielded no diagnosis, and therfore the thoracic surgeons made a pleural biopsy. This showed an epitheloid tumor , and the immune staining onfirmed that it was a malignant mesothelioma. The patient was offered cytostatic treatment but refused; she wanted to try with cost changes. She excluded meat in her diet, ate broccoli, nuts etc, and at check-up 3 months later the chest X-ray and the CT scan were normal. At follow-up, however, 18 months later there was a recurrence, ans she has now been started on chemotherapy.
Conclusion:
We have in the literature managed to find only three case reports similar to this one. An immunological reaction has been postulated to be the cause. In at least two of the cases, as in this one, there was none or only slight exposure to asbestos. In one case, there was no recurrence after 7 years, in another a single local recurrence after 6 years which was surgically removed. Odd patients which have lived for many years, even decades, without any treatment have also been described. In our own experience, the longest survivor survived 20 years with minimal symptoms. It is important to realize that good otcomes not always are due to the actions of doctors.
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-016 - Pleural Mesothelioma Incidence in Sweden: No Cecrease in Sight (ID 1053)
09:30 - 17:00 | Author(s): G.N. Hillerdal
- Abstract
Background:
Sweden was one of the first countries in the world to ban asbestos, which happened in the early mid-seventies. The use of asbestos in Sweden was thus mainly in the 1960ies. The incidence of mesothelioma started rising from around 1975 and reached a little more tha 100 cases a year in 1985, in parallell to asbestos use 30 years earlier. It has been postulated that it should start sinking in the first decade of the 2000s.
Methods:
The incidence of pleural mesothelioma for both sexes have been taken from the ofiicial Swedish pulblication "Cancer Incidence in Sweden", the latest avialable figures of which is 2012.
Results:
Since 1984, a plateau has been reached, with around 100 cases of new pleural mesotheliomas occurring in Sweden every year, sometimes a little less, more often a little more. No tendency to declining figures can be seen so far. The median age st diagnosis has remained the same since the 1960ies, 54-70 years. Furthermore, the percentage of women is the same, 15-20 % of the total.
Conclusion:
The heaviest exposure took place in Sweden around 1965; after this date, in most working places people became more aware and the exposure was diminished, but continued until early 1970ies. It has been postulated that 40 years after exposure, the risk should decline, and if so those who were 20 years old in 1970 should by now have a decreasing risk, but there are no signs of this. Since the relative risk for men and women is about the same, it is unlikely that general environmental exposure to asbestos explains the lack of decline of the curve. Interestingly, the median age at diagnosis has remained the same though most of those exposed should by now have a fairly advanced age.
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P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.08-029 - Benign Metastatizing Leiomyoma of the Uterus: 2 New Cases (ID 338)
09:30 - 17:00 | Author(s): G.N. Hillerdal
- Abstract
Background:
Middle-aged and older women can present with dyspnoea and multiple well-demarcated rounded compact lesions of the lungs in different sizes, some very big. Investigation reveals no primary tumor but many years earlier an hysterectomi has been performed due to a big myoma, which was classified as benign. Biopsies of the lesions show the same picture. This is a very rare findings but we here present two cases seen recently by us.
Methods:
Two women with large probable metastases of the lungs were investigated.
Results:
Case 1: An exsmoking 74-year old woman was referred because of dyspnoea and pulmonary infiltrates. She had two lesions, one on each side approximately 2 cm in diameter. Laboratory tests normal .PET showed only minimal uptake. Needle puncture revealed leiomymatous cells with very low proliferation. Further questioning revealed that in 2008, an hysterectomy was performed because of a very large myoma, which was benign. Re-investigation of the myoma and of the biopsy from the lung lesion showed the same picture, and there were no signs of malignancy. Case 2: A neversmoking 68-year old woman was referred because of cough and pulmonary infiltrates. Multiple rounded lesions were seen on X-ray. Biopsy showed benign cells. In 1986 -29 years earlier - an hysterectomy had been performed because of pressure symptoms and a very large benign myoma was found.
Conclusion:
The diagnosis of "Benign metastasizing leiomyoma of the uterus" was established in the two cases. The name is an oxymoron; from the clinical view it must be regarded as a low-grade malignant leiomyosarcoma. Since its first description in 1939, around 100 case reports have been published. In rare cases, metastases in other organs than the lungs can also be found. Progression is usually extremely slow, no other organs are involved, and the main symptom is a slowly progressive dyspnoea, The prognosis in the short run (years) is very good, and specific treatment is lacking. If very big, surgical removal of lesions should be considered. We will just follow these patients since they have no symptoms.
