Respiratory Medicine Case Reports (Jan 2018)

Malignant mesothelioma presenting as recurrent hydro-pneumothorax: An atypical case presentation and literature review

  • Nadia Sattar,
  • Richard Durrance,
  • Ahmed Khan,
  • Nilesh Patel,
  • Maximo Mora,
  • Artur Shalonov

Journal volume & issue
Vol. 23
pp. 152 – 155

Abstract

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Malignant Pleural Mesothelioma (MPM) is a rare pleural malignancy, with a vague presentation complicated by a decades-long latency period between environmental exposure and clinical manifestations. Spontaneous hydro-pneumothorax is a rare presentation of MPM, most often requiring invasive tissue biopsy to confirm the etiologic diagnosis. We present the case of 79-year-old male smoker with no documented history of asbestos exposure, who was found to have MPM after presenting with dyspnea and subsequently found to have recurrent hydro-pneumothorax. On Literature review of the limited documented cases of MPM with hydro-pneumothorax, we found an exclusively male population with a significant smoking history, a marked right sided pathology predominance, and a generally poor prognosis. While this corresponds with the examined case, and suggests that the presence of hydro-pneumothorax implies a high-grade tumor and significant tissue invasion, and therefore poor prognosis similar to that of stage 4 disease, it differs from more generalized case reviews of MPM, most importantly in their anatomical descriptions, prognostic indicators, and epidemiologic tendencies. Keywords: Malignant pleural mesothelioma, Hydrothorax, Pneumothorax, Hydro-pneumothorax