Metastatic Malignant Mesothelioma

History: 60 year old male with left sided chest pain. This is a case of pathology proven metastatic malignant mesothelioma. These are tumors of the pleura, and are most likely secondary to long-term asbestos exposure, in which there is a dose-response relationship and typically a latent period of 30-45 years. Asbestos plaques are not a…

radiologypics

January 30, 2013

1–2 minutes

cancer, chest, CT, MSK, nuclear medicine

History: 60 year old male with left sided chest pain.

Coronal contrast enhanced CT of the thorax shows a large lobulated soft tissue mass within the left lower hemithorax which invades the diaphragm to enter the abdomen. Also note the large soft tissue mass which invades the left lateral fifth rib.

Maximum intensity projection (MIP) of an F18 FDG-PET/CT scan shows the large left hemithorax mass which has marked FDG uptake. Multiple other lesions with avid uptake are seen, concerning for metastatic disease.

This is a case of pathology proven metastatic malignant mesothelioma. These are tumors of the pleura, and are most likely secondary to long-term asbestos exposure, in which there is a dose-response relationship and typically a latent period of 30-45 years. Asbestos plaques are not a precursor to malignant mesothelioma. While the aggressiveness of this particularly mass makes malignant mesothelioma the likely diagnosis, the differential includes metastatic adenocarcinoma, empyema, malignant thymoma, splenosis, and lymphoma.

6 responses to “Metastatic Malignant Mesothelioma”

Sarcomatoid Mesothelioma « RadiologyPics.com

January 31, 2013 at 9:35 pm

[…] diagnosis for the right lateral chest wall mass visualized in the three MR images above includes mesothelioma, primary lung carcinoma, soft tissue sarcomas such as fibrosarcoma and malignant fibrohistiocytoma, […]

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news article

February 7, 2013 at 3:18 am

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Unilateral Opaque or “White Out” Hemithorax – Differential Diagnosis « RadiologyPics.com

February 7, 2013 at 4:51 pm

[…] pneumonectomy, community acquired pneumonia, bronchogenic carcinoma, pleural masses such as mesothelioma, and finally pulmonary […]

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Asbestos Related Pleural Disease – Pleural Plaques and The Holly Leaf Sign | RADIOLOGYPICS.COM

March 12, 2013 at 7:23 am

[…] extrapleural fat. Pleural malignancies are an additional consideration, as plaques can be seen with mesothelioma and pleural metastases. Finally, pleurodesis can cause this […]

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Multiple Pleural Masses Mnemonic – MALLETS | RADIOLOGYPICS.COM

March 19, 2013 at 7:59 pm

[…] – Mesothelioma A – Adenocarcinoma L – Lymphoma L – Leukemia E – Empyema T – Thymoma […]

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