Case Report

Malignant Pleural Mesothelioma with Scalp, Cerebellar, and Finger Metastases: A Rare Case

Authors: Asiye Kanbay, MD, Kivilcim Ipek Oguzulgen, Ass. Prof, Can Ozturk, Prof, Leyla Memis, Prof, Sedat Demircan, Ass. Prof, Can Kurkcuoglu, MD, Nalan Akyurek, MD, Cuneyt Kurul, MD

Abstract

Malignant pleural mesothelioma (MPM) is a rare and asbestosis-associated tumor. MPM commonly invades locally, mostly in the lung, heart, pericardium, chest wall, and vertebrae. Distant metastasis of MPM is very rare. Here we report a patient with MPM who presented with multiple unusual distant metastases. The patient’s thorax tomography demonstrated right-sided, irregularly-thickened pleura with nodular masses and invasion of the chest wall into the subcutaneous area. The patient underwent biopsy for a subcutaneous mass in the right anterior chest wall. Pathologic examination revealed a malignant mesenchymal tumor. During follow-up, he suffered from a painful nodule on the scalp and nodules on the fingers, as well as weakness in his right arm. Cranial magnetic resonance imaging illustrated a 1 cm nodule in the left cerebellar hemisphere. Histopathologic examination of the biopsy from the nodule on the scalp revealed a typical mixed type of MPM, with calretinin, vimentin and creatine 5/6 positivity. Distant metastases can be seen in MPM and a biopsy of metastatic regions can yield the diagnosis.


Key Points


* Unexpected distant metastases can be seen in malignant pleural mesothelioma.


* Primary diagnosis can be made by the biopsy of the metastatic regions.


* Distant metastasis of malignant pleural mesothelioma is very rare.

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