Progression of Peritoneal Mesothelioma In Situ to Invasive Mesothelioma Arising in the Setting of Endometriosis With Germline BAP1 Mutation: A Case Report

Daffolyn Rachael Fels Elliott, Daffolyn R Fels Elliott, Fels Elliott DR, Travieso JL, Jennifer L Travieso, Jennifer Travieso, Sawsan As‐Sanie, Sawsan As-Sanie, Steven Hrycaj, Hrycaj SM, Steven M Hrycaj, Richard W. Lieberman, Lieberman RW, Jeffrey L. Myers, Myers JL, Huang T, Tao Huang
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2021 · vol. 41(5) , pp. 535–540 · doi:10.1097/pgp.0000000000000832 · PMID:34723845 · W3208115123
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This case report describes the progression of mesothelioma in situ to invasive epithelioid mesothelioma over 10 months in a young woman with endometriosis and a germline BAP1 mutation.

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Abstract

Mesothelioma in situ has been proposed as a precursor to malignant mesothelioma arising in the pleura or peritoneum. We report a case of malignant peritoneal mesothelioma which progressed from mesothelioma in situ over a 10-mo period in a 24-yr-old woman with stage IV endometriosis. Initial surgery showed deeply infiltrative endometriosis with progestin effect. Postoperatively the patient had intractable pelvic pain and vaginal discharge. Imaging studies were negative. Repeat laparoscopy 10 mo later revealed vesicular lesions on the omentum and pinpoint white lesions studding the small bowel, appendix, and pelvic peritoneum. A diagnosis of epithelioid mesothelioma was established on biopsy of the omentum and confirmed by immunohistochemistry showing complete loss of BRCA1-associated protein-1 (BAP1) nuclear staining. Retrospectively, BAP1 loss was identified in the cytologically bland, single-layer surface mesothelium of the prior resection specimen, consistent with mesothelioma in situ . The patient underwent genetic testing and was found to have a pathogenic germline mutation in BAP1 .

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Lung Neoplasms Lung Neoplasms Mesothelioma Mesothelioma Mesothelioma Mesothelioma Mesothelioma, Malignant Peritoneal Neoplasms Peritoneal Neoplasms Peritoneal Neoplasms Biomarkers, Tumor Biomarkers, Tumor Female Germ Cells Germ Cells Germ-Line Mutation

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References (18)

Source provenance

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