Successful lung-sparing resection of synchronous pleural mesothelioma and contralateral lung cancer

Naoko Imanishi,Hirotsugu Noguchi,Masaru Takenaka,Koji Kuroda,Kazuhiro Yatera,Yasuhiro Chikaishi,Fumihiro Tanaka,Yusuke Nabe

doi:10.1186/s40792-017-0336-9

Naoko Imanishi, Hirotsugu Noguchi + Show 6 more

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https://doi.org/10.1186/s40792-017-0336-9

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Abstract

BackgroundMalignant pleural mesothelioma (MPM) is an uncommon malignant tumor, and its synchronous occurrence with primary lung cancer is extremely rare. Here, we report the first surgical case of synchronous MPM and contralateral lung adenocarcinoma. Extrapleural pneumonectomy (EPP) combined with surgery for contralateral lung cancer may not be tolerated, and a lung-sparing procedure including pleurectomy/decortication (P/D) can be an alternative to achieve complete resection.Case presentationA 69-year-old male with right MPM and lung adenocarcinoma in the left upper lobe presented. Two lesions were judged to be synchronous MPM and lung cancer that were both potentially resectable clinical stage I diseases, and complete resection of both tumors was successfully achieved with right P/D following left upper division segmentectomy.ConclusionsP/D, not EPP, is a less invasive surgical procedure for MPM with curative intent and can be performed in combination with contralateral lung resection.

Highlights

Malignant pleural mesothelioma (MPM) is an uncommon malignant tumor, and its synchronous occurrence with primary lung cancer is extremely rare
We report the first surgical case of synchronous MPM and contralateral lung adenocarcinoma, for which complete resection was achieved by right pleurectomy/decortication (P/D) following left upper division segmentectomy
* Correspondence: ftanaka@med.uoeh-u.ac.jp 1Second Department of Surgery, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahata-nishi-ku, Kitakyushu 807-8555, Japan Full list of author information is available at the end of the article tomography (CT) and positron emission tomography (PET) scan showed right pleural effusion and thickness of the parietal pleura with a moderate uptake of flourodeoxy-glucose (FDG) (Fig. 2a, b), which was diagnosed as epithelioid MPM by thoracoscopic biopsy

Summary

Introduction

Malignant pleural mesothelioma (MPM) is an uncommon malignant tumor, and its synchronous occurrence with primary lung cancer is extremely rare. Conclusions: P/D, not EPP, is a less invasive surgical procedure for MPM with curative intent and can be performed in combination with contralateral lung resection. We report the first surgical case of synchronous MPM and contralateral lung adenocarcinoma, for which complete resection was achieved by right pleurectomy/decortication (P/D) following left upper division segmentectomy.

Results

Conclusion