2018 Volume 32 Issue 2 Pages 178-182
Most cases of malignant pleural mesothelioma develop diffusely, but rarely in a localized pattern. We herein report a patient with localized malignant pleural mesothelioma who survived without relapse for almost 5 years with only local resection.
A 60-year-old man had been exposed to asbestos for over 30 years. An abnormal shadow was noted on the left side of the chest, and abnormal uptake in the left fourth rib was observed with FDG-PET. We performed tumor resection, and 3rd and 4th rib resection with thoracoscopy. We submitted the specimens for rapid diagnosis. As malignant fibrous histiocytoma was suspected, we additionally resected approximately 3 cm. On pathology, the tumor cells were lace-to-spindle shaped and polymorphous. Anisonucleosis and irregular shapes were noted, and large nuclear bodies and necrosis were also observed. On immunostaining, the epithelial marker was positive, but the mesothelioma marker was negative; however, our diagnosis was malignant mesothelioma. Four years and ten months have passed without signs of recurrence. In some cases of malignant pleural mesothelioma, long-term survival is possible, but reports of non-chemotherapy cases are rare, and continued follow-up is necessary.
