A synchronous occurrence of breast cancer and pleural mesothelioma: a case report

Our plain-English summary of A synchronous occurrence of breast cancer and pleural mesothelioma: a case report, by Z. Ahmad, H. Jehanzeb, S.N. Hussain, et al (Journal of Medical Case Reports, 2025).

The study

• Authors: Z. Ahmad, H. Jehanzeb, S.N. Hussain, M. Umar, H. Saleem
• Journal: Journal of Medical Case Reports
• Published: 2025;19(1):25
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant mesotheliomas are aggressive forms of tumors arising from mesothelial cells. The most common type is malignant pleural mesothelioma, which progresses rapidly and leads to pleural effusion. It typically affects older men and is strongly associated with asbestos exposure. However, a few studies have reported cases of malignant pleural mesothelioma resulting from non-asbestos factors, including radiotherapy for breast cancer, viruses, chronic inflammation, and BRCA1-associated protein-1-associated genetic mutations. Breast cancer is the most common sporadic cancer among women, and a small percentage of cases are related to genetic factors, such as BRCA1/2 and BRCA1-associated protein-1 mutations. While breast cancer can be linked with other primary malignancies through germline mutations, the synchronous occurrence of breast cancer with pleural mesothelioma is extremely rare.

Case Presentation: We present the case of a 40-year-old Pashtun woman diagnosed with primary breast cancer. She underwent surgery followed by chemotherapy (paclitaxel). During chemotherapy, she developed right-sided chest pain and dyspnea. A computed tomography scan revealed pleural thickening, and a pleural biopsy confirmed the diagnosis of malignant pleural mesothelioma, with positive results for the diagnostic markers WT1 and D240.

Conclusion: This case represents a rare occurrence of synchronous breast cancer and pleural mesothelioma in a 40-year-old female, and is the first case reported in Khyber Pakhtunkhwa, Pakistan. These findings demonstrate the importance of comprehensive diagnostic testing and the potential role of genetic mutations in concurrent cancers. The challenge of simultaneously treating these cancers highlights the need for further research and the importance of multidisciplinary approaches.

© 2024. The Author(s).

In plain English

This was a case report of one patient from Khyber Pakhtunkhwa, Pakistan. A 40-year-old Pashtun woman was diagnosed with invasive (grade 3) cancer of the left breast in March 2024. She was treated with a modified radical mastectomy, followed by paclitaxel chemotherapy. At the end of July 2024 she reported a month of right-sided chest pain and breathlessness, along with weight loss. She was a non-smoker, and the report states she had no history of asbestos exposure. A chest CT scan showed nodular thickening of the right pleura (the lining around the lung) with fluid, and a biopsy confirmed pleural mesothelioma. The treating team judged local resection or chemoradiation unsuitable, so she continued paclitaxel. By the end of August 2024 her symptoms had improved. The authors called this the first documented case of its kind from Khyber Pakhtunkhwa. They wrote that the case highlights a causal relationship between the two cancers. They recommended genetic testing, citing a possible role of genetic mutations, and called for further research. A single case cannot show how often this occurs.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 40-year-old Pashtun woman in Khyber Pakhtunkhwa, Pakistan, diagnosed with left-sided invasive breast cancer (grade 3) in March 2024, who later developed malignant pleural mesothelioma
• Exposure: No asbestos exposure was reported. The patient was a non-smoker with no history of asbestos exposure. Her treatment for breast cancer was surgery and paclitaxel chemotherapy.
• Main results:
  • At the end of July 2024, the patient reported right-sided chest pain that had persisted for a month, along with breathlessness. She also had a 10 kg weight loss over 2 months.
  • Chest CT showed nodular pleural thickening on the right side with pleural effusion (fluid)
  • Thoracoscopic pleural biopsy confirmed mesothelioma. The tumor tested positive for WT1, D240 and CD45 and negative for TTF-1 and CEA. The authors noted that CD45 positivity in mesothelioma cells is relatively rare and needs further investigation.
  • The thoracic tumor multidisciplinary team judged local resection or chemoradiation unsuitable because the mesothelioma was invasive and diffuse
  • The patient continued paclitaxel at 175 mg/m2 (total dose 262.5 mg) and tolerated it well. At follow-up at the end of August 2024, her breathlessness and chest pain had improved.
• The authors' conclusion: The authors concluded that the case highlights a causal relationship between the synchronous occurrence of breast cancer and pleural mesothelioma, and that it is the first documented case of its kind from Khyber Pakhtunkhwa. They recommended genetic testing because of a potential role of genetic mutations, and called for further research and a multidisciplinary approach to treating multiple cancers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelioma, Mesothelial Cells, Pleural Effusion, Asbestos Exposure, Chronic Inflammation, Germline Mutation, Chemotherapy.

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