Perineural spread of malignant mesothelioma with spinal intramedullary involvement

Malignant pleural mesothelioma is an uncommon but aggresive malignancy. Its incidence is approximately 1.05 per 100,000 ersons in the United States, with an estimated 3200 new ases annually. Even with multimodal treatment, most commonly emetrexed-based chemotherapy, median survival is approxiately one year after diagnosis, and cure is exceedingly rare. ost patients are found to have an epithelioid histology, which s associated with a prolonged survival as compared with the arcomatoid, biphasic, and desmoplastic types. Patterns of failre after chemotherapy and surgery are predominantly local, nd mesothelioma frequently demonstrates localized direct invaion and lymphatic spread in the thorax. However, there are ery few reports of spinal cord involvement. The mechanism of pread includes direct extension or hematogenous or perineural