Yao YH, Kuo YS. Malignant pleural mesothelioma mimics thoracic empyema: A case report. World J Clin Cases 2023; 11(35): 8372-8378 [PMID: 38130617 DOI: 10.12998/wjcc.v11.i35.8372]
Corresponding Author of This Article
Yen-Shou Kuo, MD, Surgeon, Surgical Oncologist, Teacher, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325 Section 2 Chenggong Road, Neihu District, Taipei 114202, Taiwan. geniuspipi@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2023; 11(35): 8372-8378 Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8372
Malignant pleural mesothelioma mimics thoracic empyema: A case report
Ya-Hsin Yao, Yen-Shou Kuo
Ya-Hsin Yao, Department of General Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
Yen-Shou Kuo, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
Author contributions: Yao YH and Kuo YS wrote the manuscript; Kuo YS performed the thoracoscopic operation in this case; all authors have read and approved the final manuscript.
Informed consent statement: After obtaining approval from the Institutional Review Board (IRB) at Tri-Service General Hospital, the study (IRB number: C202315055) was conducted following the approved protocol. The patient provided informed consent for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare that there is no conflict of interest to disclose.
CARE Checklist (2016) statement: The present study followed the rules of the guide of the CARE checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yen-Shou Kuo, MD, Surgeon, Surgical Oncologist, Teacher, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325 Section 2 Chenggong Road, Neihu District, Taipei 114202, Taiwan. geniuspipi@gmail.com
Received: August 27, 2023 Peer-review started: August 27, 2023 First decision: September 13, 2023 Revised: September 18, 2023 Accepted: December 1, 2023 Article in press: December 1, 2023 Published online: December 16, 2023 Processing time: 109 Days and 1.6 Hours
Abstract
BACKGROUND
Thoracic empyema and malignant pleural mesothelioma (MPM) are distinct medical conditions with similar symptoms, including cough, chest pain, and breathing difficulty. We present a rare MPM case mimicking thoracic empyema. Physicians must consider MPM risks for patients exposed to building material who exhibit lobulated pleural effusions, indicating thoracic empyema.
CASE SUMMARY
A 68-year-old retired male construction worker suffered from shortness of breath and chest tightness over 10 d, particularly during physical activity. A poor appetite and 4 kg weight loss over the past 3 wk were also reported. Chest images and laboratory data concluded a tentative impression of empyema thoracis (right). Video-assisted thoracic surgery with decortication and delobulation (right) was conducted. The pathological report yielded an MPM diagnosis. Refractory pleural bilateral effusions and respiratory failure developed postoperatively, and the patient died three weeks after the operation.
CONCLUSION
Thoracic empyema and MPM are distinct medical conditions that can present similar symptoms, and video-assisted thoracic surgery facilitates an accurate diagnosis. Empyema-mimicking presentations and postoperative refractory pleural effusion may indicate a poor MPM outcome.
Core Tip: Malignant pleural mesothelioma (MPM) shows similar clinical symptoms and imaging features to thoracic empyema. In the present case, the final diagnosis was confirmed by the thoracoscopic surgery. This article could offer clinicians a hint to consider a diagnosis of MPM when treating thoracic empyema and consider thoracoscopic surgery for accurate diagnosis.
