A case of delayed recurrence of pleural mesothelioma with intradural invasion
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Updated: Apr 10, 2026
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Published on: December 21, 2019
Hidetoshi Sato1, Rui Omichi1, Yuto Nigami1
1Department of Neurosurgery, Tsukazaki Hospital, Himeji, Japan.
Background:
Pleural mesothelioma (PM) is a tumor of the pleural epithelium with a poor prognosis. Asbestos exposure is closely related to its occurrence. To date, there have been 13 reports of PM with intradural invasion.
Case Description:
A 73-year-old male was admitted with rapid progression of back pain and paraparesis. At age 67, he was diagnosed with PM (epithelial type) and underwent chemotherapy and a left thoracotomy for tumor resection. At present, the magnetic resonance newly showed T7-T9 spinal cord compressed due to an intradural tumor. Originating from the left pleura and invading the spinal canal through the intervertebral foramina, the lesion was subtotally resected. Histology confirmed that the intradural tumor lesion was a PM (biphasic type) that had transformed into a malignant tumor. Postoperatively, the patient's paraparesis improved. Despite the administration of adjuvant chemotherapy, the tumor showed regrowth 5 months later; further treatment was purely palliative care.
Conclusion:
In general, patients with PM have a poor prognosis. However, those with some favorable factors (i.e., epithelioid subtype, female sex, and early clinical stage) may survive for up to 5-years.
Insights
Pleural mesothelioma (PM) can invade the spinal canal, presenting as an intradural tumor. This rare occurrence, seen in a 73-year-old male, highlights the aggressive potential of PM.
Area of Science:
- Oncology
- Neurosurgery
- Pathology
Background:
- Pleural mesothelioma (PM) is an aggressive malignancy of the pleural lining, often linked to asbestos exposure.
- Intradural invasion by PM is exceptionally rare, with only 13 prior reports documented.
- PM typically carries a poor prognosis, though certain factors like epithelioid subtype and early stage may improve survival.
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