Advanced, recurrent mesothelioma growth mimicking an aortic dissection

Abstract

In the emergency setting, a cold, clammy, dyspnoeic patient presenting with interscapular chest pain and unequal blood pressures suggests an acute aortic dissection until proven otherwise. By means of a case report, the authors detail one such patient who presented identically to one having an acute aortic dissection. Initial assessment showed unequal blood pressures in left and right arms, a resting tachycardia and indistinct heart sounds. Fluid resuscitation failed to improve the patient's physiological parameters and they rapidly deteriorated. The medical history included mesothelioma and atrial fibrillation. Existing investigations were reviewed and after thorough consideration of the patient's premorbid state and likely prognosis, the decision was made to palliate. The patient died shortly after being transferred to the oncology ward. Imaging is therefore integral to the assessment and management of a patient in whom an aortic dissection is feared.

Advanced malignant mesothelioma mimicking acute contained thoracic aortic rupture

“…Although rare, complications of malignant pleural mesotheliomas have mimicked acute thoracic vascular pathology [4,5]. Retrospectively, the acute onset of chest pain in our patient was attributed to intratumour haemorrhage and the increased density of the periaortic fluid collection signified peritumour bleeding; this acute change resulted in hypotension.…”

Lung cancer mimicking aortic dissecting aneurysm in a patient with situs inversus totalis

“…3,4 A review of the literature revealed that cases of thoracic mesothelioma mimicking ADA have been reported; however, few reports of lung cancer presenting with symptoms suggestive of ADA have been documented. 5,6 In our case, this tumor presented unique growth by surrounding the aorta and symptoms of intermittent chest pain, which resulted in a false preoperative diagnosis because of similar clinical characteristics to ADA.…”