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Published on: December 21, 2019
Haemorrhagic Brain Metastasis From Malignant Pleural Mesothelioma: A Rare Case
Cleofina Furtado1, Sachin Srivastava1, Sanjeev Nayak1
1Department of Diagnostic and Interventional Radiology, University Hospitals of North Midlands NHS Trust, Stoke On Trent, GBR.
Abstract:
Malignant pleural mesothelioma (MPM) typically has a short median survival of only a few months from diagnosis, with death usually due to thoracic disease. This has led to the belief in the past that mesothelioma rarely has distant metastasis, with cerebral metastasis accounting for only 3%. The multiple cases of brain metastasis from MPM recorded so far were discovered after death at autopsy. This report describes a rare case of known malignant mesothelioma with distant haemorrhagic metastasis to the brain, reviews current literature about its metastatic potential to the brain and discusses prognosis and management. We also review the imaging evaluation in known MPM patients with suspected intracranial involvement and describe typical imaging findings of parenchymal brain metastasis on computed tomography (CT) and magnetic resonance imaging (MRI).
Insights
Malignant pleural mesothelioma (MPM) rarely spreads to the brain. This case highlights hemorrhagic brain metastasis from MPM, emphasizing the need for advanced imaging in diagnosis and management.
Area of Science:
- Oncology
- Neurology
- Radiology
Background:
- Malignant pleural mesothelioma (MPM) has a poor prognosis, with most deaths occurring from thoracic disease.
- Distant metastasis from MPM is considered rare, with cerebral metastasis historically reported in only 3% of cases.
- Previous instances of brain metastasis were primarily identified post-mortem.
Observation:
- This report details an unusual case of malignant pleural mesothelioma with confirmed hemorrhagic metastasis to the brain.
- The patient had a known diagnosis of MPM, and the metastasis was identified during life.
- Literature review on MPM's metastatic potential to the brain was conducted.
Findings:
- The case demonstrates that MPM can metastasize to the brain, presenting as hemorrhagic lesions.
- Imaging evaluation, including CT and MRI, is crucial for detecting intracranial involvement in MPM patients.
- Typical imaging findings of parenchymal brain metastasis were described.
Implications:
- This finding challenges the historical perception of MPM's limited metastatic potential to the brain.
- Early detection of brain metastasis through appropriate imaging may influence prognosis and management strategies.
- Further research is warranted to understand the mechanisms and frequency of MPM brain metastasis.
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