Malignant pleural mesothelioma presenting as spontaneous pneumothorax: a case series and review

Abstract

Background Malignant pleural mesothelioma (MPM) is thought to arise from the mesothelial cells that line the pleural cavities. Most patients initially experience the insidious onset of chest pain or shortness of breath, and it rarely presents as spontaneous pneumothorax. Case reports We report four patients who presented in this manner. Three of the patients were exposed to asbestos directly or indirectly at shipyards during World War II; the fourth was exposed as an insulator's wife. Two of our cases were not recognized to have MPM on histologic examination at first thoracotomy and remained asymptomatic for 12 and 22 months, respectively. In none of the patients described herein, was spontaneous pneumothorax the cause of death. Conclusions Since many people were exposed to asbestos during and after World War II, spontaneous pneumothorax in a patient with the possibility of such exposure should raise the suspicion of malignant pleural mesothelioma. Am. J. Ind. Med. 38:219–223, 2000. © 2000 Wiley‐Liss, Inc.

Sneaky Diagnosis of Pleural Malignant Mesothelioma in Thoracic Surgery: All That Glitters Is Not Gold

“…The first pneumothorax complicating MPM was reported by Eisenstadt in 1956 [ 30 ]. In 2000, Alkhuja et al [ 31 ] reported the first case series of four patients with MPM presenting as spontaneous pneumothorax. As stated by Prasad and colleagues in 2013 [ 32 ], until then, in the literature, less than 35 cases of MPM presenting as spontaneous pneumothorax have been collected.…”

Malignant pleural mesothelioma presenting as a spontaneous pneumothorax

“…It is generally known that most patients present with insidious onset of chest pain and shortness of breath [1] . Spontaneous pneumothorax is a rare presentation of MPM [2] . Spontaneous pneumothorax secondary to probable MPM was originally reported in 1956 by Eisenstadt [3] .…”

“…Most patients initially experience substantial chest pain or dyspnea [1] . It rarely presents as spontaneous pneumothorax [2] . We here report two cases and review a series of 14 cases in Japan.…”

Spontaneous massive hemopneumothorax: Double trouble with a twist

“…[5] Malignant pleural mesothelioma usually presents with nonspecific chest symptoms, due to the presence of extensive intrathoracic disease for many months before diagnosis and is rarely asymptomatic[5] with occult disease diagnosed on decorticated pleural biopsies in SP. [6] Our patient presented with acute spontaneous massive hemopneumothorax, postmyocardial infarction, and PTCA considered to be related to cardiac intervention and anticoagulation. However, malignant cells in pleural fluid cytology led to thoracoscopic pleural biopsy establishing the diagnosis of epithelioid mesothelioma.…”