Recurrent hydropneumothorax as a presenting feature of malignant mesothelioma

Our plain-English summary of Recurrent hydropneumothorax as a presenting feature of malignant mesothelioma, by K. Guha, D. Jones, J.H. Hull, et al (European Journal of Internal Medicine, 2008).

The study

• Authors: K. Guha, D. Jones, J.H. Hull, T.B. Ho
• Journal: European Journal of Internal Medicine
• Published: 2008;19(1):63-4
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 73-year-old former smoker with previous occupational exposure to asbestos presented with a pneumothorax that was initially managed by simple aspiration. Despite this, it re-accumulated and a bronchopleural fistula was suspected. A video-assisted thoracoscopic procedure was performed and revealed an abnormally thickened pleura that turned out to be a mesothelioma. All persistent pneumothoraces should be investigated.

In plain English

This was a case report about one patient, a 73-year-old man seen at a UK hospital. The article's abstract described him as a former smoker with previous occupational exposure to asbestos. The case description said he had worked mainly in the aluminium trade and for 10 years at a coal-fired power station, and named no fiber type. He had three weeks of right-sided chest pain and breathlessness. An X-ray showed air and fluid around the right lung (a hydropneumothorax). Removing 1020 ml of air seemed to resolve it, but it returned a month later. A CT scan showed multiple non-calcified pleural plaques, and bronchoscopy was normal. A chest drain bubbled when he coughed, which suggested an air leak from the lung. During keyhole chest surgery, surgeons saw marked pleural thickening, and biopsies showed malignant epithelioid mesothelioma. The authors concluded that cancers are an uncommon cause of a collapsed lung but should be considered when one persists despite appropriate management. A single case does not show how often this happens.

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 73-year-old man, an ex-smoker with a 40-pack-year history who had stopped 13 years earlier, seen at Frimley Park Hospital, Camberley, Surrey, UK
• Exposure: Previous occupational asbestos exposure, stated in the article's abstract. The case description gives his work as mainly the aluminium trade plus 10 years at a coal-fired power station. No fiber type, product or dose is given.
• Main results:
  • Aspiration of 1020 ml of air appeared to resolve the right hydropneumothorax at first.
  • One month later the right hydropneumothorax had re-accumulated.
  • CT of the chest showed multiple non-calcified pleural plaques. Bronchoscopy was normal.
  • Over 72 hours the chest drain kept bubbling when he coughed, suggesting a bronchopleural fistula (an air leak from the lung).
  • At video-assisted thoracoscopy, marked pleural thickening was biopsied and showed malignant epithelioid mesothelioma. He was referred to oncologists, with prophylactic port-site radiotherapy among the planned treatment.
• The authors' conclusion: The authors concluded that malignancies are an uncommon underlying cause of pneumothorax but should be kept in mind if a pneumothorax persists despite appropriate management.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Occupational Exposure, Pneumothorax, Pleura, Mesothelioma.

Related studies

• Lepidic intrapulmonary growth of malignant mesothelioma presenting as recurrent hydropneumothorax — H. Wu, G. Tino, et al. (1996)
• Diffuse epithelioid malignant mesothelioma of the pleura presenting as a hydropneumothorax and vertebral body invasion — C.A. Hinkamp, S.N. Dalal, et al. (2020)
• Malignant pleural mesothelioma presenting with a spontaneous hydropneumothorax: a report of 2 cases — H.Z. Saleh, E. Fontaine, et al. (2012)
• Simultaneous bilateral spontaneous hydropneumothorax: a rare presentation of bilateral malignant pleural mesothelioma — H.E. Fayed, V.K. Woodcock, et al. (2013)
• Pleural mesothelioma presenting as recurrent pneumothoraces — R.J. Bright-Thomas, R.Y. Ahmed, et al. (2010)
• Recurrent hydropneumothorax: An unusual presentation for malignant pleural mesothelioma — D. DeLapp, C. Chan, et al. (2016)

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