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Abstract

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Article in Japanese

Case Report

Epitheloid malignant pleural mesothelioma relapse one year after surgery of sarcomatoid malignant pleural mesothelioma

Hajime Yoshiia  Kiyoshi Matsuoa  Keiichi Fujiwaraa  Toshiro Yoneia  Toshio Satoa  Ichiro Yamadorib  Akio Andouc 

aDepartment of Respiratory Medicine, National Hospital Organization, Okayama Medical Center
bDepartment of Clinical Pathology, National Hospital Organization, Okayama Medical Center
cDepartment of Chest Surgery, National Hospital Organization, Okayama Medical Center

ABSTRACT

A 69-year-old man presented with left chest pain and exertional dyspnea. The chest X-ray showed massive left pleural effusion. The CT showed left pleural effusion and a tumor on the left diaphragm that was more than 8 cm and did not enhance. The MRI showed a tumor that was a low signal by T1-weighted image and a high signal by T2-weighted image. The tumor that was on the left diaphragm and along the chest wall was resected by the video-assisted thoracoscopic surgery. A postoperative histological examination revealed that this tumor was malignant. We thought it to be a leiomyosarcoma, malignant peripheral nerve sheath tumor or a sarcomatoid malignant pleural mesothelioma, but no conclusion has been reached. One year after surgery, a new lesion appeared and rapidly proliferated. A biopsy under the thoracoscope was performed. As a result, the patient was diagnosed with epitheloid malignant mesothelioma, and the chemotherapy that was begun consisted of cisplatin and pemetrexed. We again examined the first resected tumor in detail, and we concluded that it was sarcomatoid malignant mesothelioma. We considered this to be a rare case of malignant pleural mesothelioma.

KEYWORDS

Sarcomatoid malignant pleural mesothelioma  Epitheloid malignant pleural mesothelioma  Video-assisted thoracic surgery  Immunohistochemical staining 

Received 18 Mar 2011 / Accepted 6 Jan 2012

AJRS, 1(4): 315-321, 2012

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