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Sarcomatoid mesothelioma presenting as a mediastinal mass: A case report
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1
Department of Medicine, School of Medicine, Baylor College of Medicine, Houston, Texas,
United States of America
2
Department of Pathology and Immunology, Baylor College of Medicine and Ben Taub Hospital, Houston, Texas,
United States of America
3
Department of Medicine, Baylor College of Medicine, Houston, Texas,
United States of America
Submitted: 2 August 2024 | Accepted: 25 September 2024 | Published: 10 October 2024
(This article belongs to the Special Issue New Developments in Lung Cancer Research, Diagnosis, Treatment, and Prognosis)
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract
Sarcomatoid mesothelioma (SM) is a subtype of mesothelioma, a deadly cancer strongly related to asbestos exposure. Herein, we present the case of a 50-year-old female who presented with back pain and non-specific symptoms for approximately 9 months. The diagnostic investigation revealed a large, centrally necrotic mass in the thorax that appeared to arise from the mediastinum and surrounded vital structures, including the superior vena cava. A biopsy of the thoracic mass revealed SM. The patient developed hematemesis, and emergent endoscopy revealed a gastric ulcer composed of malignant SM cells, a rare finding in pleural mesothelioma. Her disease was too advanced for surgical resection and conventional therapy. She tragically died weeks after diagnosis. The findings of this report highlight the varied presentation of SM to underscore the importance of early diagnosis and treatment of patients in improving overall survival.
Keywords
Mediastinal mass
Dyspnea
Back pain
Sarcomatoid mesothelioma
Lung cancer
Funding
None.
Conflict of interest
The authors declare no conflicts of interest.
References
- Alpert N, van Gerwen M, Taioli E. Epidemiology of mesothelioma in the 21st century in Europe and the United States, 40 years after restricted/banned asbestos use. Transl Lung Cancer Res. 2020;9(Suppl 1):S28-S38. doi: 10.21037/tlcr.2019.11.11
- Billè A, Okiror L, Harling L, et al. Analysis of survival of patients with metastatic malignant pleural mesothelioma. Tumori. 2021;107(2):110-118. doi: 10.1177/0300891620926239
- Mott FE. Mesothelioma: A review. Ochsner J. 2012;12(1):70-79.
- Klebe S, Brownlee NA, Mahar A, et al. Sarcomatoid mesothelioma: A clinical-pathologic correlation of 326 cases. Modern Pathol. 2010;23(3):470-479. doi: 10.1038/modpathol.2009.180
- Leigh J, Rogers AJ, Ferguson DA, et al. Lung asbestos fiber content and mesothelioma cell type, site, and survival. Cancer. 1991;68(1):135-141. doi: 10.1002/1097-0142(19910701)68:1<135:AID-CNCR28 20680125>3.0.CO;2-S
- Huang J, Chan SC, Pang WS, et al. Global incidence, risk factors, and temporal trends of mesothelioma: A population-based study. J Thorac Oncol. 2023;18(6):792-802. doi: 10.1016/j.jtho.2023.01.095
- Hernández-Blanquisett A, Álvarez-Londoño A, Martinez- Avila MC, et al. Asbestos and cancer in Latin America and the Caribbean: We may have won some battles, but definitely not the war. J Public Health Res. 2021;11(2):2549. doi: 10.4081/jphr.2021.2549
- Singh R, Frank AL. Analysis of the Indian Government’s position on the use of asbestos and its health effects. Public Health Action. 2023;13(2):50-52. doi: 10.5588/pha.23.0013
- Li X, Ding D, Xie W, et al. Risk assessment and source analysis of heavy metals in soil around an asbestos mine in an arid plateau region, China. Sci Rep. 2024;14(1):7552. doi: 10.1038/s41598-024-58117-4
- Mann S, Khawar S, Moran C, et al. Revisiting localized malignant mesothelioma. Ann Diagn Pathol. 2019;39:74-77. doi: 10.1016/j.anndiagpath.2019.02.014
- Finn RS, Brims FJH, Gandhi A, et al. Postmortem findings of malignant pleural mesothelioma: A two-center study of 318 patients. Chest. 2012;142(5):1267-1273. doi: 10.1378/chest.11-3204
- Pezzuto A, Mariotta S, Fioretti F, et al. Metastasis to the colon from lung cancer presenting with severe hyponatremia and dyspnea in a young male: A case report and review of the literature. Oncol Lett. 2013;5(5):1477-1480. doi: 10.3892/ol.2013.1208
- Agaimy A, Wünsch PH. Epithelioid and sarcomatoid malignant pleural mesothelioma in endoscopic gastric biopsies: A diagnostic pitfall. Pathol Res Pract. 2006;202(8):617-622. doi: 10.1016/j.prp.2006.05.002
- Clopton B, Long W, Santos M, Asarian A, Genato R, Xiao P. Sarcomatoid mesothelioma: Unusual findings and literature review. J Surg Case Rep. 2022;2022(11):rjac512. doi: 10.1093/jscr/rjac512
- Mehta K, Mehta S, Joshi M, Bharadwaj HR, Ardeshana G, Tenkorang PO. Challenging diagnosis of sarcomatoid hepatic mesothelioma: A case report with review of literature. Ann Med Surg (Lond). 2023;85(10):5123-5126. doi: 10.1097/MS9.0000000000001148
- Amatya VJ, Kushitani K, Mawas AS, et al. MUC4, a novel immunohistochemical marker identified by gene expression profiling, differentiates pleural sarcomatoid mesothelioma from lung sarcomatoid carcinoma. Mod Pathol. 2017;30(5):672-681. doi: 10.1038/modpathol.2016.181
- Assié JB, Crépin F, Grolleau E, et al. Immune-checkpoint inhibitors for malignant pleural mesothelioma: A French, multicenter, retrospective real-world study. Cancers (Basel). 2022;14(6):1498. doi: 10.3390/cancers14061498
- Mansfield AS, Symanowski JT, Peikert T. Systematic review of response rates of sarcomatoid malignant pleural mesotheliomas in clinical trials. Lung Cancer. 2014;86(2):133-136. doi: 10.1016/j.lungcan.2014.08.017