Intrapulmonary desmoplastic mesothelioma in a young adult – Case report

Abstract

Introduction: Desmoplastic mesothelioma typically represents an extremely rare histological subtype of sarcomatoid malignant mesothelioma that usually presents with a diffuse pattern of growth. A marked increase in mesothelioma is predicted in developing countries, where asbestos usage is increasing exponentially. Only a few case series have been reported in the Indian literature where mesotheliomas have been analysed on routine histology and IHC. Case Presentation: We are reporting a case of a 28 years old man came with complaints of gradually progressive central non radiating chest pain for 3months with unremarkable physical findings. CT thorax revealed well defined homogenous slightly lobulated soft tissue attenuating mass lesion in anterior epicardial fat pad, biopsy reported benign spindle cell tumour possibly neural origin. Interventions: Patient underwent thoracotomy and tumour excision. Post-operative histopathological examination showed desmoplastic mesothelioma. The final diagnosis of intrapulmonary desmoplastic mesothelioma was confirmed by pathological and immunohistochemical examination. The patient underwent 6 cycles of PEM/CARBO adjuvant chemotherapy followed by adjuvant radiation of 50.4 Gy by VMAT Technique. Conclusion: Desmoplastic mesothelioma is a rare pathology and rarely seen in young patients. Desmoplastic mesothelioma continues to have a poor prognosis due to its highly malignant, aggressive, and refractory nature to local treatment which necessitates the early intervention to improve the survival.