Malignant mesothelioma with bone metastases

Malignant mesothelioma has rarely been reported to metastasize to bone. This is a report of a 71-year-old man who presented with pleural mesothelioma. After a course of chemotherapy, the patient developed lower back pain. Plain X-ray and bone scan were negative for metastases, but magnetic resonance imaging (MRI) revealed multiple metastatic lesions to the thoracolumbar vertebrae. Subsequent lumbar spine biopsy confirmed the presence of malignant mesothelioma. The patient then received radiation therapy. This report illustrates an unusual presentation for malignant mesothelioma and shows that, in addition, when bone metastases are clinically suspected, MRI may be a useful adjunct to more conventional imaging approach.