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Published on: December 21, 2019
Malignant pleural and peritoneal mesothelioma consequential to brief indirect asbestos exposure
Bharati Singhal1, Supreethi Kohli1, Anu Singhal1
1Department of Radiology, ESI Model Hospital and Post-Graduate Institute of Medical Sciences and Research, Basaidarapur, New Delhi, India.
Abstract:
This report highlights that pleural and peritoneal mesothelioma can occur without direct asbestos exposure as was seen in our young patient. The patient had indirect exposure for as short as 3 months as a child, 15 years earlier, when she was residing with her miner father in the district of Jharia, Jharkhand, which is an asbestos-rich mining area in eastern India. The patient presented with chest pain and breathlessness. Chest X-ray showed opaque right hemithorax. Typical contrast- computed tomography (CECT) enhanced radiological features included nodular, soft-tissue attenuation and homogenously enhancing rind-like mass causing scalloping of the underlying lung and liver. Similar lesions were also found involving the pelvis. Diagnosis of malignant mesothelioma was confirmed on lung biopsy. Under-reporting of exposure is usual because it is unrecognized by both patients and investigators.
Insights
Malignant mesothelioma, a cancer of the lung lining, can develop from indirect asbestos exposure, even in young patients. This case shows that even brief childhood exposure in asbestos-rich areas can lead to mesothelioma years later.
Area of Science:
- Oncology
- Environmental Medicine
- Radiology
Background:
- Malignant mesothelioma is strongly linked to asbestos exposure.
- Diagnosis is often delayed due to under-reported or unrecognized exposure history.
Observation:
- A young patient presented with symptoms of chest pain and breathlessness.
- Radiological imaging revealed characteristic features of mesothelioma affecting the pleura, peritoneum, and pelvis.
Findings:
- Malignant mesothelioma was confirmed via lung biopsy.
- The patient had a history of indirect, short-term asbestos exposure during childhood in an asbestos-rich mining region.
Implications:
- This case underscores the risk of mesothelioma from indirect and unrecognized asbestos exposure.
- Highlights the importance of thorough exposure history assessment in diagnosing mesothelioma, particularly in younger individuals.
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