Abstract
Malignant mesothelioma is an aggressive neoplasm associated with poor prognosis. Identification of in-situ phase of malignant mesothelioma can help detect disease at an earlier stage and potentially improve outcome by early therapeutic intervention. The concept of malignant mesothelioma in-situ (MIS) has re-emerged, diagnostic criteria based on use of immunohistochemistry and molecular techniques have been described recently and the latest WHO classification of lung tumors includes MIS as a distinct diagnostic entity. Here we present morphologic and immunohistochemical findings from a patient presenting with multiple peritoneal and pleural in-situ malignant mesothelioma lesions with eventual progression to pleural invasive malignant mesothelioma over a protracted period of 13 years. There are very few well documented cases of malignant mesothelioma in-situ and this unique case provides insight into the morphologic variants and natural behavior of malignant mesothelioma in-situ over an extended period of time.
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