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Solid papillary mesothelial tumor.

Andrew Churg1, Nolwenn Le Stang2, Sanja Dacic3

  • 1Department of Pathology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada. achurg@mail.ubc.ca.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|September 4, 2021
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Summary
This summary is machine-generated.

A novel peritoneal tumor, termed solid papillary mesothelial tumor, presents as benign or low-grade nodules. These distinct lesions require differentiation from malignant mesothelioma for accurate patient management.

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Area of Science:

  • Pathology
  • Oncology
  • Surgical Pathology

Background:

  • Peritoneal mesothelial tumors encompass a spectrum of neoplasms.
  • Distinguishing benign from malignant mesothelial lesions is critical for patient prognosis and treatment.

Purpose of the Study:

  • To characterize a previously undescribed type of peritoneal mesothelial tumor.
  • To establish diagnostic criteria and assess the clinical behavior of these novel lesions.
  • To differentiate these tumors from malignant mesotheliomas.

Main Methods:

  • Histopathological examination of nine peritoneal tumors.
  • Immunohistochemistry for BAP1 loss.
  • Fluorescence in situ hybridization (FISH) for CDKN2A deletion.
  • RNA sequencing (RNA-seq) for molecular profiling.
  • Array comparative genomic hybridization (Array CGH).

Main Results:

  • Nine cases of circumscribed nodular mesothelial tumors were identified in women aged 30-72.
  • Tumors exhibited bland mesothelial cells, sharp borders, and lacked BAP1 loss or CDKN2A deletion.
  • RNA-seq showed these tumors clustered distinctly from diffuse malignant mesotheliomas.
  • No recurrent mutations or abnormalities in typical mesothelioma genes were found.
  • Follow-up revealed no deaths, recurrences, or metastatic disease, indicating a benign or very low-grade nature.

Conclusions:

  • Solid papillary mesothelial tumor is a newly identified entity with distinct morphological and molecular features.
  • These tumors appear to be benign or very low-grade, necessitating separation from malignant mesotheliomas.
  • Accurate diagnosis is crucial to avoid misclassification and inappropriate aggressive treatment.