Malignant Pleural Mesothelioma with the Presentation of a Lobulated Cyst and Mediastinal Involvement-A Case Report

Malignant mesothelioma is a relatively rare tumor; two-thirds of all patient can be traced to having had asbestos contact. The prognosis of malignant mesothelioma remains poor, due to the high recurrence rate, invasion predisposition, and resistance to therapies. Herein, we report the case of a 58-year-old man presenting with progressive dyspnea and chest pain for 2 months. The chest X-ray revealed: 1) a mediastinal mass with a tracheal deviation to the left, and 2) right massive pleural effusion with one loculated component at the right upper lung. Malignant pleural mesothelioma was diagnosed using thoracoscopy with a biopsy. No history of asbestos exposure was found. He has undergone 5 chemotherapy treatments with novelbine and cisplatin in six months(from Aug., 2003 to Feb., 2004). The lesion has remained stationary throughout the course. A review of the literatures has revealed that malignant mesothelioma with a cystic component that invades the mediastinum is rarely reported.