Pleural mesothelioma with solitary simultaneous subcutaneous tissue metastasis of the abdominal wall at diagnosis - First clinical documentation

Introduction Pleural mesothelioma with metastasis to the subcutaneous tissue of the abdominal wall at first diagnosis and without penetration into the peritoneum is an extremely rare clinical presentation. Pleural mesothelioma is a malignant neoplasm of mesodermal origin and arises from multipotential mesothelial or subserosal cells of the pleura, pericardium and peritoneum. Aims and objectives This is the first clinical documentation of pleura mesothelioma simultaneously metastasized to the subcutaneous tissue of the abdominal wall. Methods Patients with pleura mesothelioma have low survival rate. A 55- year- old man was referred to our center due to increasing dyspnea and a painful periumbilical mass in the anterior abdominal wall. CT- scan revealed both advanced mesothelioma of the pleura and a tumor mass confined to the subcutaneous fatty tissue without penetration through the peritoneum. Video assisted-thoracoscopy confirmed the diagnosis of epithelioid pleuramesothelioma, which was also confirmed by a biopsy of the periumbilical mass. Systemic chemotherapy with cisplatin and pemetrexed was initiated. Results Under the ongoing systemic chemotherapy, the evaluation revealed partial remission of pleura mesothelioma and its subcutaneous manifestation of the abdominal wall. During the follow- up evaluations, we could observe improved clinical conditioning of our patient. Conclusion Mesothelioma is a aggressive malignant manifestation with resistence toward many therapies. This is the first ever cllinical documentation of a patient with pleura mesothelioma and simultaneous subcutaneous manifestation of abdominal wall.