- Metastatic Disease to the Pleura
- Lung Cancer (36% of all pleural metastasis)
- Lymphoma (10%) - strong possibility given this patients history of testicular lymphoma
- Less commonly: gastric cancer, invasive thymoma, leukemia, or renal cell carcinoma)
- Primary Malignant Pulmonary Mesothelioma
Definitive tissue diagnosis was obtained with Video Assisted Thoracoscopic Surgery (VATS):
- Malignant Pleural Mesothelioma (MPM): Epithelial Histology
- MPM is the most common primary neoplasm of the pleura
- MPM has an insidious onset typically characterized by recurrent unilateral exudative pleural effusion, pleural nodules, masses and/or plaque-like growth with invasion of the fissures and encasement of the lung.
- In the United States it is reported that:
- 2,000 to 3,000 new cases of MPM occur each year
- Up to 80% have prior asbestos exposure history (7% to 10% lifetime risk in heavily exposed individuals) - however this man never reports exposure to asbestos.
- In a series of 31 patients at CSMC, 19 (61%) patients had no history of asbestos exposure
- Male:Female ratio is between 2-6:1
- Peak Age: 6th to 7th decade of life
- Poor prognosis: 85% die within one year of diagnosis
- Epithelial (50%), Mixed (34%) and Sarcomatoid (15%): worst prognosis
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