Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Apr;98(15):e15147.
doi: 10.1097/MD.0000000000015147.

Primary malignant mesothelioma of the diaphragm with liver invasion: A case report and review of literature

Wen-Jing Huang  1 , Zhi-Han Li, Zhao Wang, Mai-Qing Yang, Hong-Tao Xu
Affiliations
Review

Primary malignant mesothelioma of the diaphragm with liver invasion: A case report and review of literature

Wen-Jing Huang et al. Medicine (Baltimore). 2019 Apr.

Erratum in

Abstract

Rationale: Malignant mesothelioma is a malignant tumor with poor prognosis, which usually originates in the pleura, peritoneum, and pericardial cavity. Mesotheliomas that originate from the diaphragm are very rare. Here, we report a case of primary malignant mesothelioma of the diaphragm with liver invasion.

Patient concerns: A 66-year-old woman was admitted to our hospital because of a "liver space-occupying lesion," without any special clinical symptoms. Imaging examinations suggested a cystic-solid mixed lesion in the right lobe of the liver.

Diagnosis: The tumor was diagnosed as epithelioid mesothelioma of the diaphragm with liver invasion.

Intervention: The patient underwent abdominal surgery in our hospital to remove the diaphragmatic mass, liver mass, and part of the diaphragm.

Outcomes: The postoperative course was uneventful.

Lessons: Primary diaphragmatic malignant mesothelioma is very rare and may involve liver or lung tissue and be mistaken for liver or lung tumor. Accurate diagnosis depends on careful pathological examination. Immunohistochemical staining is very useful to distinguish this tumor from other liver or diaphragmatic tumors.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Computed tomography imaging of the tumor. Computed tomography showed a round lesion in the right liver with relatively clear border. The lesion was about 8.2 cm × 8.2 cm × 7.3 cm, and elevated from the liver surface, closely adhering to the right diaphragm.
Figure 2
Figure 2
Morphological change of the tumor. (A) Epithelioid tumor cells formed microcysts, cords, or small nests. The stroma exhibited fibrosis and hyaline change (H&E staining, ×200). (B) The tumor cells were large and round or oval shape with abundant, clear cytoplasm. The nuclei were blunt, ovoid, and eccentric without nucleoli. The mitotic figures were very few (H&E staining, ×400).
Figure 3
Figure 3
Immunohistochemical staining of the tumor. The tumor cells were strongly positive for Wilms tumor 1 (A), cytokeratin 5/6 (B), calretinin (C), D2–40 (D), and vimentin (E) staining. (F) Ki-67 proliferative index was about 5% to 10%. (S–P method, ×200).
See this image and copyright information in PMC

References

    1. McCroskey Z, Staerkel G, Roy-Chowdhuri S. Utility of BRCA1-associated protein 1 immunoperoxidase stain to differentiate benign versus malignant mesothelial proliferations in cytologic specimens. Diagn Cytopathol 2017;45:312–9. - PubMed
    1. Wu D, Hiroshima K, Yusa T, et al. Usefulness of p16/CDKN2A fluorescence in situ hybridization and BAP1 immunohistochemistry for the diagnosis of biphasic mesothelioma. Ann Diagn Pathol 2017;26:31–7. - PubMed
    1. An YX, Wei LX. Malignant mesothelioma clinicopathological analyses of 100 cases. Zhen Duan Bing Li Xue Za Zhi 2015;22:156–8. (Chinese).
    1. Zhang Y, Gu YH. One case of diffuse high differentiated papillary mesothelioma of the peritoneum. Zhen Duan Bing Li Xue Za Zhi 2018;06:457–9. (Chinese).
    1. Schunselaar LM, Zwart W, Baas P. Targeting BAP1: a new paradigm for mesothelioma. Lung Cancer 2017;109:145–6. - PubMed