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Case Reports
. 2022 Mar 3;15(1):149-155.
doi: 10.1159/000522114. eCollection 2022 Jan-Apr.

Mesothelioma: A Case in a Diagnostic Timeline and the Efficiency of Robot-Assisted Surgery

Paul Zarogoulidis  1   2 , Kosmas Tsakiridis  2 , Thomas Zarampoukas  3 , Katerina Zarampouka  3 , Dimitris Hatzibougias  4 , Christos Tolis  5 , Stavros Tryfon  6 , Maria Saroglou  6 , Aris Ioannidis  7 , Dimitris Matthaios  8 , Christoforos Kosmidis  1
Affiliations
Case Reports

Mesothelioma: A Case in a Diagnostic Timeline and the Efficiency of Robot-Assisted Surgery

Paul Zarogoulidis et al. Case Rep Oncol. .

Abstract

We present a case of a 65-year-old male with a difficulty to diagnose mesothelioma. To be specific, three attempts were made to diagnose the disease, and only with a large sample performed with robot-assisted surgery, our pathologists were able to identify the malignancy. The novelty for our case is mostly based on the timeline of the diagnosis along with the tissue samples where we present the course of the transformation from benign to malignancy. All tissue biopsies were checked by two independent pathologists. Conclusively, diagnosis for small local lesions should be performed with an endoscopic method, video-assisted or robot-assisted.

Keywords: Atypia; Biopsy; CT-guided biopsy; Mesothelioma; Thorax; Video-assisted thoracic surgery.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Left; the convex probe, right; during the first biopsy.
Fig. 2
Fig. 2
a–b M28186_HE ×400 and M28186_HE ×400_2: hyperplastic mesothelial cells without atypia, in a hemorrhagic, fibrous, and hyalinized stroma (H&E ×400). c M28186_Ki67 ×400_3: Ki67 proliferation index was less than 5%.
Fig. 3
Fig. 3
a Dense collagenous fibrous tissue (Η&Ε ×100). b Foreign body giant-cell reaction (Η&Ε ×200).
Fig. 4
Fig. 4
Left: computed tomography with the lesion and right: the mass during the RATS and pleurodesis. RATS, robot-assisted thoracic surgery.
Fig. 5
Fig. 5
a Spindle and few epithelioid cells in fibrotic stroma (Η&Ε ×100). b Tumor cells are positive for CKAE1/AE3 (immunostain ×200). c Tumor cells show limited positivity for WT1 (immunostain ×200).
Fig. 6
Fig. 6
a Limited positivity for D2-40 (immunostain ×200). b Limited positivity for EMA (immunostain ×200). c Enough cells show nuclear positivity for Ki-67 (immunostain ×200).
See this image and copyright information in PMC

References

    1. Barbieri PG, Calisti R, Calabresi C. Pleural malignant mesotheliomas from environmental exposures to asbestos in Italy. Epidemiol Prev. 2021 Jul-Aug;45((4)):289–295. - PubMed
    1. Monaco SE, Brcic L, Dacic S. State-of-the-art cytology of pleural fluid, focusing on the diagnosis of mesothelioma. Cytopathology. 2022 Jan;33((1)):57–64. - PubMed
    1. Girolami I, Lucenteforte E, Eccher A, Marletta S, Brunelli M, Graziano P, et al. Evidence-based diagnostic performance of novel biomarkers for the diagnosis of malignant mesothelioma in effusion cytology. Cancer Cytopathol. 2021 Sep 3; Epub ahead of print. - PubMed
    1. Foroulis CN, Kleontas AD, Tagarakis G, Nana C, Alexiou I, Grosomanidis V, et al. Massive chest wall resection and reconstruction for malignant disease. Onco Targets Ther. 2016;9:2349–2358. - PMC - PubMed
    1. Porpodis K, Zarogoulidis P, Boutsikou E, Papaioannou A, Machairiotis N, Tsakiridis K, et al. Malignant pleural mesothelioma: current and future perspectives. J Thorac Dis. 2013 Sep;5((Suppl 4)):S397–406. - PMC - PubMed

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