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Respir Med Case Rep. 2018 Feb 24;23:152-155. doi: 10.1016/j.rmcr.2018.02.006. eCollection 2018.

Malignant mesothelioma presenting as recurrent hydro-pneumothorax: An atypical case presentation and literature review.

Author information

1
Department of Internal Medicine, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States.
2
Department of Pathology, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States.
3
Department of Pulmonology, Jamaica Hospital Medical Center, 8900 Van Wyck Expressway, Jamaica NY 11420, United States.

Abstract

Malignant Pleural Mesothelioma (MPM) is a rare pleural malignancy, with a vague presentation complicated by a decades-long latency period between environmental exposure and clinical manifestations. Spontaneous hydro-pneumothorax is a rare presentation of MPM, most often requiring invasive tissue biopsy to confirm the etiologic diagnosis. We present the case of 79-year-old male smoker with no documented history of asbestos exposure, who was found to have MPM after presenting with dyspnea and subsequently found to have recurrent hydro-pneumothorax. On Literature review of the limited documented cases of MPM with hydro-pneumothorax, we found an exclusively male population with a significant smoking history, a marked right sided pathology predominance, and a generally poor prognosis. While this corresponds with the examined case, and suggests that the presence of hydro-pneumothorax implies a high-grade tumor and significant tissue invasion, and therefore poor prognosis similar to that of stage 4 disease, it differs from more generalized case reviews of MPM, most importantly in their anatomical descriptions, prognostic indicators, and epidemiologic tendencies.

KEYWORDS:

Hydro-pneumothorax; Hydrothorax; Malignant pleural mesothelioma; Pneumothorax

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