A rare case of a huge malignant pleural mesothelioma presenting in the posterior mediastinum

Respirology Case Reports 2024 July 9 [Link]

Yuta Mori, Chihiro Kato, Hideo Yamakawa, Mariko Sugiura, Kensuke Fukumitsu, Satoshi Fukuda, Yoshihiro Kanemitsu, Takehiro Uemura, Tomoko Tajiri, Hirotsugu Ohkubo, Yutaka Ito, Tetsuya Oguri, Takayuki Murase, Akio Niimi

Abstract

We report a case of a 69-year-old woman with pleural mesothelioma presenting in the posterior mediastinum with a maximum diameter of 25 cm. She had a chronic cough and a pleural effusion was noted on chest X-ray. The examination of the effusion showed high hyaluronic acid levels, and mesothelioma was suspected. A chest computed tomography scan showed a huge mediastinal mass, which caused rapid progression of respiratory failure and compression of the heart. Sufficient tissue samples could not be obtained before death. The patient died approximately 1 month after the initial visit, and a pathological autopsy was performed. The diagnosis of malignant pleural mesothelioma was made. Malignant pleural mesothelioma with a huge posterior mediastinal mass such as in this case is considerably rare; however, it is a rapidly progressing form of the disease and is reported here as an important differential diagnosis for mediastinal tumours.