[Pleural metastases can simulate a mesothelioma]

Area of Science:

• Oncology
• Pathology

Background:

• Stomach cancer (gastric adenocarcinoma) is a common malignancy often diagnosed at advanced, inoperable stages.
• Metastatic disease significantly contributes to mortality, with over 75% of patients dying from metastases despite therapeutic advances.

Observation:

• A patient presented with thoracic pain and recurrent pleural effusions, initially suspected to be pleural mesothelioma.
• Histological examination revealed the cause to be metastatic gastric cell carcinoma, not primary pleural mesothelioma.

Findings:

• Gastric carcinoma can present with atypical symptoms, including chest pain due to pleural metastases.
• Distinguishing metastatic cancer from primary pleural tumors like mesothelioma is critical for accurate diagnosis and treatment.

Implications:

• This case underscores the importance of considering non-pleural primary tumors in the differential diagnosis of unexplained pleural effusions and thoracic pain.
• Raising awareness of gastric cancer's potential for pleural metastasis can improve diagnostic timeliness and patient outcomes.