A Rare Clinical Presentation of Malignant Pleural Mesothelioma With Central Nervous System Metastases: A Case Report

Cureus 2025 September 14 [Link]

Magdalena A Miernik-Skrzypczak, Elwira Misztela-Lisiecka, Piotr Nowakowski, Anna Strozak, Grazyna Waska

Abstract

Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer arising from the pleural mesothelial cells, most often associated with long-term asbestos exposure. Symptoms are typically nonspecific, including shortness of breath, chest pain, and pleural effusion, which may delay diagnosis. We report a case of a 63-year-old woman with bilateral MPM and subsequent central nervous system (CNS) metastases. She received systemic chemotherapy with cisplatin and pemetrexed, achieving a partial radiological response. Several months after completing treatment, she developed neurological symptoms. Imaging revealed multiple CNS metastases. Palliative radiotherapy provided temporary control; however, her condition progressively deteriorated. This case illustrates an unusual presentation and metastatic pattern of MPM in a female patient, highlighting diagnostic and therapeutic challenges, as well as the aggressive nature of the disease despite palliative care.