Malignant Mesothelioma Presenting as a Gradually Enlarging Pneumothorax

Prasad, Ashish; Olsen, Diana; Pothapregada, Sriram

doi:10.1155/2013/374960

Cited by 4 publications

(7 citation statements)

References 4 publications

(4 reference statements)

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“…This situation can be considered as a distant metastasis through the blood; it could also be a second primary MPM since it occurred 8 years after the treatment of the first tumor. Nevertheless, there are many markers, both clinical and biological, of prognosis in MPM [7]. The MPM in our patient seemed to be a very slow progressing biological subtype and with the advancement of the first MPM, the disease in the left hemithorax may be occurred.…”

Section: Discussionmentioning

confidence: 63%

“…There are very few MPM cases presented with pneumothorax in the literature [7,8]. This is the first case report involving a patient who had a MPMrelated recurrent pneumothorax that developed in the remaining lung years after the EPP of the other side.…”

Section: Discussionmentioning

confidence: 86%

“…The mechanism of pneumothorax is not clear in patients with MPM, but it has been argued that it can develop as a result of the rupture of necrotic tumor nodules [8]. There are very few MPM cases presented with pneumothorax in the literature [7,8]. This is the first case report involving a patient who had a MPMrelated recurrent pneumothorax that developed in the remaining lung years after the EPP of the other side.…”

Section: Discussionmentioning

confidence: 93%

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Left-sided malignant pleural mesothelioma presenting with recurrent pneumothorax 7 years after the right pleuropneumonectomy

et al. 2016

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Malignant pleural mesothelioma (MPM) is an extremely aggressive tumor arising from the pleura with a median survival of approximately 9-12 months. It can rarely present as a spontaneous pneumothorax. We herein reported a 65-year-old female patient with the left-sided MPM presenting with episodes of recurrent spontaneous pneumothorax. She had undergone the right pleuropneumonectomy due to the right-side MPM 7 years ago. She admitted to our clinic with diagnosis of left pleural effusion. The patient underwent pleural biopsy and talc pleurodesis by thoracoscopy. Histologic study showed the epithelial subtype of MPM. She received chemotherapy nine times. Seven years after pleuropneumonectomy, she had recurrent left-sided spontaneous pneumothorax four times that was treated one by one with tube thoracostomy. We did not perform surgical treatment because of the unsuitable status of the patient. It should be kept in mind that, when pneumothorax develops in the remaining lung after a single-sided pneumonectomy, this may be due to the tumor.Eur Res J 2016;2(3):240-243

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 93%

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Left-sided malignant pleural mesothelioma presenting with recurrent pneumothorax 7 years after the right pleuropneumonectomy

et al. 2016

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“…Average age: 67 years old; 100% male predominance; marked tobacco history; ubiquitous right thorax involvement; and epithelioid tissue subtype was ubiquitously described [ [6] , [7] , [8] , [9] , [10] , [11] , [12] ]. Case Report Age Sex Environmental Exposure Tobacco Exposure Chief Complaint Chest Roentograph Cytology Biopsy Subtype of MPM DeLapp et al [ 12 ] 67 M Asbestos Yes Cough, Dyspnea Right hydropneumothorax Negative VATS- Biopsy + Epithelioid Fayed et al [ 11 ] 69 M Asbestos No Cough, Dyspnea Bilateral hydropneumothorax Negative VATS- Biopsy + Not clarified Saleh et al [ 10 ] 71 M Asbestos Yes Chest Pain, Dyspnea Right hydropneumothorax Negative VATS- Biopsy + Epithelioid Saleh et al [ 10 ] 70 M Unclear Yes Chest Pain, Dyspnea Right hydropneumothorax Not Declared Open Thoracotom Epithelioid Wu et al [ 9 <...>…”

Section: Case Presentationmentioning

confidence: 99%

“…Large scale and minimally symptomatic progressive hydro-pneumothorax carries a wide range of differentials, and malignant mesothelioma is an obscure diagnosis which requires a high index of suspicion and extensive occupational history investigation on the part of the clinician. Spontaneous hydro-pneumothorax is a rare presentation of MPM, with a literature review of PubMed (search criteria: Mesothelioma, pneumothorax, hydro-pneumothorax) revealing 9 total case reports [ [6] , [7] , [8] , [9] , [10] , [11] , [12] ]. We present a case of a MPM without documented asbestos exposure, presenting as recurrent right-sided hydro-pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

Malignant mesothelioma presenting as recurrent hydro-pneumothorax: An atypical case presentation and literature review

Sattar

Durrance

Khan

et al. 2018

Respiratory Medicine Case Reports

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Malignant Pleural Mesothelioma (MPM) is a rare pleural malignancy, with a vague presentation complicated by a decades-long latency period between environmental exposure and clinical manifestations. Spontaneous hydro-pneumothorax is a rare presentation of MPM, most often requiring invasive tissue biopsy to confirm the etiologic diagnosis. We present the case of 79-year-old male smoker with no documented history of asbestos exposure, who was found to have MPM after presenting with dyspnea and subsequently found to have recurrent hydro-pneumothorax. On Literature review of the limited documented cases of MPM with hydro-pneumothorax, we found an exclusively male population with a significant smoking history, a marked right sided pathology predominance, and a generally poor prognosis. While this corresponds with the examined case, and suggests that the presence of hydro-pneumothorax implies a high-grade tumor and significant tissue invasion, and therefore poor prognosis similar to that of stage 4 disease, it differs from more generalized case reviews of MPM, most importantly in their anatomical descriptions, prognostic indicators, and epidemiologic tendencies.

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A Rare Presentation of Minimally Invasive Mesothelioma as a Large Tension Pneumothorax

2023

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Development of mesothelioma is associated with asbestos exposure. Common presentations are with pleural-based plaques invading the chest wall and/or pleural effusion on chest imaging. The intent of this case report is to describe a rare presentation of mesothelioma, which presented atypically as a large tension pneumothorax. A 93-year-old male presented with a history of dyspnea that started after a coughing episode. On physical examination he was hemodynamically stable, but was hypoxic requiring 2L of supplemental oxygen. Computed tomography of the chest revealed a large right tension pneumothorax. A chest tube was placed and connected to suction (−20cmH20), but he continued to have an unresolving air leak over the following 2-week period. Upon video-assisted thoracotomy there were no blebs or adhesions seen. Right apical wedge resection and talc pleurodesis were performed. Pathologic examination revealed an atypical mesothelial cell proliferation with minimal, focal invasion into the pulmonary parenchyma. Tumor spread along the visceral pleura was thought to be the underlying cause of the pneumothorax. The surgical margins were uninvolved by the tumor, and the patient was later discharged home in stable condition. This was a rare presentation of what could best be described as minimally invasive mesothelioma arising in a background of probable mesothelioma in situ, which presented atypically as a large tension pneumothorax. This case highlighted the importance of establishing a pathologic diagnosis from pleural effusion cytology and/or pleural biopsy in persons presenting with spontaneous pneumothorax, and the difficulty in confirming a pathologic diagnosis of early mesothelial neoplasia.

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Malignant Mesothelioma Presenting as a Gradually Enlarging Pneumothorax

Cited by 4 publications

References 4 publications

Left-sided malignant pleural mesothelioma presenting with recurrent pneumothorax 7 years after the right pleuropneumonectomy

Left-sided malignant pleural mesothelioma presenting with recurrent pneumothorax 7 years after the right pleuropneumonectomy

Malignant mesothelioma presenting as recurrent hydro-pneumothorax: An atypical case presentation and literature review

A Rare Presentation of Minimally Invasive Mesothelioma as a Large Tension Pneumothorax

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