bims-mesote 2025-06-08 papers

Issue of 2025–06–08
four papers selected by
Laura Mannarino, Humanitas Research

Thorac Cancer. 2025 Jun;16(11): e70098

A Case of Duodenal Metastasis From Malignant Pleural Mesothelioma Diagnosed by Gastrointestinal Endoscopy Following Progressive Anemia During Salvage Chemotherapy.

Naruhiko Ichiyama, Hiromichi Yamane, Takako Saitou, Masafumi Miura, Ayaka Mimura, Yoko Kosaka, Tatsuyuki Kawahara, Yasunari Nagasaki, Nobuaki Ochi, Hidekazu Nakanishi, Hideyo Fujiwara, Nagio Takigawa.

Malignant pleural mesothelioma (MPM) primarily progresses through direct invasion into the lung and pleura and is a refractory tumor in which asbestos exposure is a major underlying factor in most cases. Hematogenous metastasis of MPM is not uncommon in advanced stages, and reports suggest that metastatic sites may impact prognosis. Gastrointestinal metastases, ranging from the stomach to the colon, have been sporadically observed, but metastases to the small intestine and duodenum are exceedingly rare. Here, we report a case in which duodenal metastasis of MPM was endoscopically identified during the patient's lifetime while undergoing salvage chemotherapy following treatment with an immune checkpoint inhibitor and cytotoxic chemotherapy. Given the rarity and clinical significance of such cases, we present this report with a review of the relevant literature.

Keywords: duodenal metastasis; esophagogastroduodenoscopy; malignant mesothelioma

DOI: https://doi.org/10.1111/1759-7714.70098

Front Public Health. 2025 ;13 1588415

Sex differences in asbestos exposure.

Krishna Patel, Stephanie Tuminello, Emanuela Taioli.

Background: Although the association between exposure to asbestos and malignant mesothelioma has been established, occupational exposure has been historically present in males, while the ascertainment of female exposures is more nuanced. We reviewed the literature to assess differences in environmental exposure in mesothelioma cases according to sex.
Methods: A new PubMed search was conducted with the key words "mesothelioma" and "environmental exposure" on October 11, 2024 with a start date of January 1, 2016, to supplement our previous qualitative review that included publications up through June 2016. Studies conducted in occupational settings were excluded.
Results: Out of the 26 eligible papers, 11 were excluded because they did not report information on exposure by sex, leaving 15 published studies that were added to the 9 from our previous qualitative synthesis (24 total studies). 19 studies were cross-sectional, 2 were cohort and 3 were case control studies. The average NIH Study Quality tool score was 7.4/14 (minimum 3, maximum 12). Occupational exposure was more frequently observed in males than in females. While a male to female ratio favored males, there was variation in the strength of the association. There was a large proportion of cases with "unknown exposure," and these were more frequently observed among female cases. In some studies, up to 40% of female cases had unknown exposure profiles. Quality assessment showed a generalized lack of standardization in the definition of environmental exposures across studies.
Conclusion: Although recent studies have continued to improve our understanding of environmental exposure to asbestos and other elongated fibers, challenges remain, including but not limited to lack of rigorous, high-quality evidence and difficulty standardizing definitions across countries and datasets to enable appropriate comparison across studies.

Keywords: asbestos exposure; cancer risk; environmental risk; epidemiology; non-occupational exposure

DOI: https://doi.org/10.3389/fpubh.2025.1588415

Oncol Lett. 2025 Jul;30(1): 358

Malignant mesothelioma with a novel BAP1 germline frameshift mutation treated with dual immune checkpoint inhibitors: A case report.

Na Zhou, Mingying Wu, Chenyu Wang, Mingming Yuan, Yuejuan Cheng, Huanwen Wu, Xin Gao, Shuangni Yu, Lin Zhao.

Germline pathogenic mutation of the BAP1 gene is a common molecular event in malignant mesothelioma (MM). A patient with a positive family history of tenacious peritoneal effusions presented with hydropneumothorax and suffered from recurrent pleural and peritoneal effusions since. Tuberculosis (TB) was assumed by preceding clinicians who prescribed futile anti-TB regimens. Finally, a diagnostic laparoscopy and omental biopsy revealed the histology of MM. Next-generation sequencing uncovered a novel BAP1 germline frameshift mutation (c. 1077_1083delinsTG, pPhe360fs), which was rated as pathogenic due to its potential to introduce a termination codon, resulting in nonsense-mediated mRNA decay and due to the fact of BAP1 protein nuclear loss in tumor tissue. Dual immunotherapy with nivolumab and ipilimumab was given for 3 cycles and only achieved stable disease. Steven-Johnson syndrome occurred afterward and was relieved after steroid treatment. The present study reported a case of MM with a new BAP1 frameshift mutation, treated by dual immune checkpoint inhibitors, achieving a modest drug effect and serious skin-related adverse events.

Keywords: BAP1 germline mutation; Steven-Johnson syndrome; case report; dual immune checkpoint inhibitors; malignant mesothelioma

DOI: https://doi.org/10.3892/ol.2025.15104