Cerebral metastasis from malignant pleural mesothelioma

Abstract

Malignant mesothelioma is an uncommon, highly invasive tumor derived from the mesothelial cells of pleura or peritoneum characterized by poor outcome. Mesothelioma was thought to metastasize locally only via direct invasion and not have distant spread. Distant metastases were discovered mostly on post-mortem examination. The authors present a case of 62-year-old man with pleural mesothelioma and brain metastasis.

Identification of prognostic and bone metastasis​‐related alternative splicing signatures in mesothelioma

“…Generally, mesothelioma originates from the mesothelial cells of pleura and peritoneum 3 . Exposure of asbestos is an exclusive risk factor and effusion is always the main clinical symptom 4,5 . There is no uniform treatment for mesothelioma.…”

“… 3 Exposure of asbestos is an exclusive risk factor and effusion is always the main clinical symptom. 4 , 5 There is no uniform treatment for mesothelioma. Although surgical resection at early stage may be an effective method, the prognosis for patients is still poor, with a high metastasis rate to contralateral pleura and lung, liver, bone and brain via direct invasion, lymphatic and hematogenous routes.…”

Cerebral metastases of malignant mesothelioma

“…After starting in the parietal pleura, mesothelioma most often spreads locally in the visceral pleura and onwards to the chest wall, diaphragm, mediastinum and regional lymph nodes [ 1 , 2 ]. Distant metastasis is rarely seen in this form of cancer, possibly due to the rapid progression of the disease [ 3 , 5 , 6 ]. In this present case, the patient’s mesothelioma was first discovered 6 months prior as the patient was worked up for pulmonary embolism and persistent pulmonary hypertension.…”

“…It is believed that metastatic disease enters the blood vessels and ultimately enters the central nervous system due to a disruption in the blood–brain barrier. However, these figures are determined based on post-mortem studies [ 4 , 5 ]. Brain metastases are often associated with poor survival outcomes and pose unique treatment challenges as these lesions are detected in the late stages of the disease.…”

Commentary: Mesothelioma … moving the needle on locoregional control has invited aggressive treatment options for limited distant metastases

“…Case reports of oligometastatic mesothelioma to the brain have been reported dating back to 1995. 1 , 2 These reports have highlighted local aggressive therapy with limited long-term survival. In this issue of JTCVS Techniques , Li and colleagues 3 have presented long-term survival (>5.5 years) of a patient with oligometastatic intracranial disease 2 years after initial treatment of an epithelioid mesothelioma.…”