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A Case of Pulmonary Embolism with Sarcomatoid Malignant Pleural Mesothelioma with Long-Term Pleural Effusion

Rumeng Gu1,2, Luxi Jiang1, Ting Duan1

  • 1Department of Respiratory Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.

Oncotargets and Therapy
|July 23, 2021
PubMed
Abstract

Insights

This case report details a rare instance of sarcomatoid malignant pleural mesothelioma (MPM) co-occurring with pulmonary embolism. Early and accurate diagnosis via pleural biopsy is crucial for this aggressive cancer with a poor prognosis.

Area of Science:

  • Oncology
  • Pulmonology
  • Pathology

Background:

  • Malignant pleural mesothelioma (MPM) is an aggressive cancer of the pleura, with incidence rising due to asbestos exposure and pollution.
  • Sarcomatoid MPM, a rare subtype, presents a particularly poor prognosis.
  • Co-occurrence of pulmonary embolism with sarcomatoid MPM is exceptionally uncommon.

Observation:

  • A 75-year-old male with asbestos exposure history presented with chest pain and dyspnea.
  • Initial diagnosis suggested pulmonary embolism causing pleural effusion; treatment provided temporary relief.
  • Recurrent symptoms and persistent unexplained pleural effusion led to further investigation.

Findings:

  • Computed tomography pulmonary angiography (CTPA) indicated pulmonary embolism.
  • Pathological and immunohistochemical examination of pleural biopsy specimens confirmed sarcomatoid MPM.
  • The patient's persistent symptoms despite initial treatment highlighted diagnostic challenges.

Implications:

  • Sarcomatoid MPM with pulmonary embolism is a rare and aggressive condition requiring high clinical suspicion.
  • Prompt diagnosis through pleural biopsy, including morphology and immunohistochemistry, is vital.
  • PET-CT guided pleural biopsy offers a less invasive option for diagnosis in select patients.
Keywords:
asbestosmalignant pleural mesotheliomapleural effusion

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