Pleuro-peritoneal Mesothelioma

Abstract

ABSTRACT

Introduction: Malignant mesothelioma is an insidious tumor that originates in the mesothelial surfaces of the pleural and peritoneal cavities, the tunica vaginalis, or the pericardium. Coexistence in more than one pleural cavity is rare.

Objective: To present the clinical and imaging characteristics of a patient with pleuro-peritoneal mesothelioma.

Case presentation: A 59-year-old male patient from an urban area with no toxic habits presented with general syndrome and dyspnea related to moderate physical exertion. He also reported severe abdominal pain and abdominal distension. The P/A chest X-ray showed the presence of a moderate right pleural effusion, and the abdominal ultrasound showed the presence of ascites. Cytology of the pleural and intra-abdominal aspiration fluid suggested a malignant etiology. Positron emission tomography combined with computed axial tomography was particularly useful in the diagnosis, showing intense hypermetabolism in the peritoneum extending to the pleura. Exploratory laparoscopic biopsy allowed the diagnosis of epithelioid mesothelioma to be established. The patient began treatment with polychemotherapy and achieved a partial response after three cycles, but with a sluggish progression secondary to the toxicity of the cytostatic treatment.

Conclusions: The low frequency of cases in which both locations coexist suggests an individual genetic predisposition.