Minute localized malignant pleural mesothelioma coexisting with multiple adenocarcinomas

Area of Science:

• Pulmonology and Thoracic Oncology
• Diagnostic Pathology
• Surgical Oncology

Background:

• Lung adenocarcinoma is a common malignancy, often associated with smoking.
• Malignant pleural mesothelioma (MPM) is a rare cancer linked to asbestos exposure.

Observation:

• A 64-year-old female patient presented with multiple ground-glass opacities on chest CT.
• Initial biopsy confirmed bronchioloalveolar carcinoma, leading to surgical resection.
• A concurrent, incidental 6 mm pleural nodule was discovered during surgery.

Findings:

• Postoperative histology revealed minute localized malignant pleural mesothelioma (LMPM) coexisting with multiple lung adenocarcinomas.
• The patient had no history of smoking or asbestos exposure, making the dual diagnosis exceptionally rare.

Implications:

• This case underscores the possibility of rare coexisting thoracic malignancies, even in patients without typical risk factors.
• Highlights the critical role of comprehensive histopathological analysis for accurate diagnosis and treatment planning.
• Suggests a need to consider less common etiological factors in specific patient presentations.