Radiotherapy-Induced Pleural Mesothelioma in a Childhood Leukaemia Survivor: A Case Report

We report the case of a 41-year-old woman who developed an epithelioid-type pleural mesothelioma (PM) decades after treatment for childhood acute myeloid leukaemia (AML), who was treated with chemotherapy and total body irradiation (TBI). The diagnosis was confirmed by thoracoscopic pleural biopsy and immunohistochemical staining. Although PM is classically associated with asbestos exposure, the patient had no known history of exposure. This case report highlights the fact that PM can occur as a late-onset secondary malignancy following radiation therapy in childhood cancer survivors. Although radiation-induced PM has been reported primarily in survivors of Hodgkin lymphoma or breast cancer, incidences following treatment for leukaemia are exceptionally rare. This case report highlights the importance of considering prior therapeutic irradiation, including total-body irradiation, as a potential etiological factor for non-asbestos-related PM. It also emphasises the need for the long-term surveillance and monitoring of childhood cancer survivors, particularly those who have received radiation therapy.