Localized intrapulmonary desmoplastic mesothelioma: A case report
Article Sidebar
Main Article Content
Abstract
Introduction: Desmoplastic Malignant Mesothelioma (DMM) is a rare histological subtype of sarcomatoid malignant mesothelioma arising most frequently in the pleura or peritoneum and less frequently in the lung parenchyma.
Patient concerns: A 52-year-old female with no apparent asbestos exposure was referred for consultation in our center after 1 month of cough and no concomitant symptoms of chest.
Diagnosis: Chest computed Tomography (CT) revealed a localized mass measuring 4.5 x 3.9 cm in the right lung middle lobe with inhomogeneous enhancement following injection of contrast, and without pleural lesions, considered a primary intrapulmonary desmoplastic mesothelioma.
Interventions: Surgical intervention was performed.
Outcomes: Following complete tumor resection, the patient declined to receive chemotherapy or radiotherapy. The final diagnosis of intrapulmonary desmoplastic mesothelioma was confirmed by pathological and immunohistochemical examination. In addition, no local tumor recurrence was observed within 10 months of follow-up.
Conclusion: Even elderly female patients with localized pulmonary masses without significant pleural lesions should not excluded the possibility of malignant mesothelioma in the lungs.
Article Details
Copyright (c) 2019 Liu M, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Galateau-Salle F, Churg A, Roggli V, Travis WD, World Health Organization Committee for Tumors of the Pleura. The 2015 World Health Organization Classification of Tumors of the Pleura: Advances since the 2004 Classification. J Thorac Oncol. 2016; 11: 142-154. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26811225
Hida T, Hamasaki M, Matsumoto S, Abe S, Takakura K, et al. Diffuse intrapulmonary malignant mesothelioma presenting with miliary pulmonary nodules: A case report. Pathol Int. 2015; 65: 318-323. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25759091
Larsen BT, Klein JR, Hornychová H, Nuti R, Thirumala S. Diffuse intrapulmonary malignant mesothelioma masquerading as interstitial lung disease: a distinctive variant of mesothelioma. Am J Surg Pathol. 2013; 37: 1555-1564. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23797722
Giansanti M, Bellezza G, Guerriero A, Pireddu A, Sidoni A. Localized Intrasplenic Mesothelioma: A Case Report. Int J Surg Pathol. 2014; 22: 451-455. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24050959
Espinal-Witter R, Servais EL, Klimstra DS, Lieberman MD, Yantiss RK. Localized intrapancreatic malignant mesothelioma: a rare entity that may be confused with other pancreatic neoplasms. Virchows Arch. 2010; 456: 455-461. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20148337
Serter A, Buyukpinarbasili N, Karatepe O, Kocakoc E. An unusual liver mass: primary malignant mesothelioma of the liver: CT and MRI findings and literature review. Jpn J Radiol. 2015; 33: 102-106. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25518822
Hasegawa M, Sakai F, Sato A, Tsubomizu S, Arimura K, et al. FISH analysis of intrapulmonary malignant mesothelioma without a clinically detectable primary pleural lesion: an autopsy case. Jpn J Clin Oncol. 2014; 44: 1239-1242. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25425731
Rossi G, Cavazza A, Turrini E, Costantini M, Casali C, et al. Exclusive intrapulmonary lepidic growth of a malignant pleural mesothelioma presenting with pneumothorax and involving the peritoneum. Int J Surg Pathol. 2006; 14: 234-237. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16959711
Klebe S, Brownlee NA, Mahar A, Burchette JL, Sporn TA, et al. Sarcomatoid mesothelioma: a clinical-pathologic correlation of 326 cases. Mod Pathol. 2010; 23: 470-479. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20081811
Ishikawa R, Kikuchi E, Jin M, Fujita M, Itoh T, et al. Desmoplastic malignant mesothelioma of the pleura: autopsy reveals asbestos exposure. Pathol Int. 2003; 53: 401-406. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12787316
Hashimoto K, Okuma Y, Hosomi Y, Hishima T. Malignant mesothelioma of the pleura with desmoplastic histology: a case series and literature review. BMC cancer. 2016; 16: 718. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27599565
Cantin R, Al-Jabi M, McCaughey WT. Desmoplastic diffuse mesothelioma. Am J Surg Pathol. 1982; 6: 215-222. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7102900
Husain AN, Colby TV, Ordóñez NG, Allen TC, Attanoos RL, et al. Guidelines for pathologic diagnosis of malignant mesothelioma: 2012 update of the consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med. 2013; 137: 647-667. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28686500
Ettinger DS, Wood DE, Akerley W, Bazhenova LA, Borghaei H, et al. NCCN Guidelines Insights: Malignant Pleural Mesothelioma, Version 3.2016. J Natl Compr Canc Netw. 2016; 14: 825-836. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27407123