Malignant pleural mesothelioma detected by spontaneous pneumothorax

Our plain-English summary of Malignant pleural mesothelioma detected by spontaneous pneumothorax, by A. Makidono, M. Matsusako, K. Oikado, et al (Japanese Journal of Radiology, 2010).

The study

• Authors: A. Makidono, M. Matsusako, K. Oikado, Y. Saida, M. Otsuji, M. Otawa, K. Suzuki, K. Inai, S. Ishikawa
• Journal: Japanese Journal of Radiology
• Published: 2010;28(7):547-51
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report a middle-aged man, without occupational or environmental exposure to asbestos, who presented with spontaneous pneumothorax. Computed tomography showed a 13-mm right apical mass. He underwent tumorectomy and was diagnosed with malignant pleural mesothelioma. A local recurrence with multiple and diffuse pleural involvement later appeared. The patient eventually underwent panpleuropneumonectomy, recovered well, and has been doing well for 18 months.

In plain English

This case report described one patient: a 44-year-old man who worked at a car-parking facility and had no history of asbestos exposure. He was diagnosed with a right-sided pneumothorax (collapsed lung), which came back and was repaired by endoscopic thoracotomy. Computed tomography showed a 13 mm nodule at the top of the right chest, and a biopsy was diagnosed as epithelioid mesothelioma. The pneumothorax recurred 2 weeks later. Open surgery then removed the tumor, which mainly involved the parietal pleura with some invasion of the visceral pleura, along with part of the lung. The final diagnosis was malignant epithelioid mesothelioma. Five months after surgery, a scan showed a small nodule at the surgical site and several scattered nodules in the right pleural cavity. The patient underwent right-sided panpleuropneumonectomy followed by radiation therapy and was reported well 18 months later. The authors found no tumor spread along the chest tube, trocar or incision tracts. They concluded that malignant pleural mesothelioma could appear as a small solitary pleural nodule. They could not determine how the tumor caused the pneumothorax.

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 (one patient)
• Who was studied: One 44-year-old man, an employee of a car-parking facility, treated at St. Luke's International Hospital, Tokyo, Japan
• Exposure: No asbestos exposure: the article states the patient had no history of asbestos exposure; no fiber type or dose is involved
• Main results:
  • The patient presented with a right-sided pneumothorax diagnosed on X-ray
  • The pneumothorax recurred and was repaired by endoscopic thoracotomy
  • CT showed a nodule 13 mm in longest diameter at the right apex
  • The biopsy specimen was diagnosed as epithelioid mesothelioma
  • Pneumothorax recurred 2 weeks after the endoscopic thoracotomy
  • At open surgery the tumor mainly involved the parietal pleura, with some invasion of the visceral pleura
  • The tumor was removed with partial resection of the lung; the final pathological diagnosis was malignant epithelioid mesothelioma
  • Final pathological diagnosis: malignant epithelioid mesothelioma
  • Five months after surgery, CT showed a small nodule at the surgical site and several scattered nodules in the right pleural cavity
  • The patient underwent right-sided panpleuropneumonectomy followed by radiation therapy
  • The patient was reported well 18 months later
  • No malignant seeding was found along the chest tube, thoracoscopy trocar or surgical incision tracts
• The authors' conclusion: The authors concluded that malignant pleural mesothelioma could appear as a small solitary pleural nodule and potentially extend to the adjacent visceral pleura
• Limitations the authors state:
  • The authors could not determine the precise mechanism by which the tumor caused the pneumothorax

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Pneumothorax, Environmental Exposure.

Related studies

• Pleural granuloma mimicking malignancy 42 years after slurry talc injection for primary spontaneous pneumothorax — S. Tenconi, L. Luzzi, et al. (2010)
• Simultaneous bilateral spontaneous pneumothorax in a patient with peritoneal and pleural papillary mesothelioma — P. Höllinger, D. Gaeng (1997)
• Spontaneous pneumothorax and lung carcinoma: should one consider synchronous malignant pleural mesothelioma? — T.A. Flood, H.S. Sekhon, et al. (2009)
• Lung function 22-35 years after treatment of idiopathic spontaneous pneumothorax with talc poudrage or simple drainage — P. Lange, J. Mortensen, et al. (1988)
• Spontaneous pneumothorax and pulmonary malignant disease--a syndrome sometimes associated with cavitating tumours. Report of nine new cases, four with metastases and five with primary bronchial tumours — F.W. Wright (1976)
• Malignant pleural mesothelioma presenting as spontaneous pneumothorax: a case series and review — S. Alkhuja, A. Miller, et al. (2000)

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