2016 Volume 56 Issue 7 Pages 1022-1027
Background. Malignant pleural mesothelioma often spreads locally into the adjacent tissues. However, it rarely invades the spinal canal. Case. In May 2007, a 69-year-old man presented with an abnormal shadow on a chest X-ray, and was diagnosed with malignant pleural mesothelioma of the right lung (epithelioid-type). He underwent various treatments, including chemotherapy and thermotherapy. However, he developed chest and back pain on the right-hand side and weakness of both lower extremities. He was therefore admitted to our hospital in September 2014. After admission, he developed paraplegia of the lower extremities and bladder and rectal disturbance. Spinal magnetic resonance imaging (MRI) showed that the tumor had invaded the cervical, thoracic, and lumbar epidural space through the Th8/9 intervertebral foramen. His neurological symptoms were temporarily improved by the administration of a corticosteroid. However, he died of respiratory failure due to tumor progression approximately 2 months after admission. On pathological autopsy the malignant pleural mesothelioma was observed to have extensively invaded the epidural space and the spinal dura mater. Conclusion. Malignant pleural mesothelioma can invade the spinal canal through the intervertebral foramen. When a patient with malignant pleural mesothelioma develops radicular symptoms, such as radiating pain, paralysis, and numbness, physicians should consider the possibility that the tumor has invaded the spinal canal.
