Localized Intrasplenic Mesothelioma

Abstract

Malignant mesothelioma is a primary neoplasm of the serosal membranes that usually presents with a diffuse pattern of growth. However, cases of localized mesotheliomas have been described. The predominant localization is the pleura; peritoneum and pericardium being rarer localizations. Only few cases of true intraparenchymal mesothelioma arising in organs such as liver, gonads, lung, and pancreas have been described. We report a case of an otherwise healthy 48-year-old man without asbestos exposure with a nodule of 3 cm in diameter, localized in the spleen, discovered incidentally at the ultrasonographic examination, for which histopathological and immunohistochemical findings were consistent with epithelioid mesothelioma: large round cells with eosinophil dense cytoplasm and macronucleoli and with immunohistochemical positivity for pancytokeratins, calretinin, Wilms tumor-1, and others markers of mesothelial differentiation. The diagnosis of localized intrasplenic epithelioid malignant mesothelioma was carried out. To the best of our knowledge, this is the first case of a localized intrasplenic mesothelioma published in the indexed literature.

Primary Sarcomatoid Malignant Mesothelioma of the Pancreas

“…Unlike conventional peritoneal mesothelioma, peritoneum metastasis and cavity effusion are rare at the time of initial diagnosis in solid organ cases, such as the liver 1 and the spleen. 2 The therapy for pancreatic mesothelioma is primarily surgical. Radiotherapy and chemotherapy have very limited effect in pancreatic malignant mesothelioma, and non-surgical therapy has only been suggested in a few cases with very extensive and inoperable lesions.…”

Localized intrapulmonary desmoplastic mesothelioma: A case report

“…Desmoplastic mesothelioma is a relatively rare histological subtype of mesothelioma with sarcomatoid histology (1) arising most frequently in the pleura, peritoneum or pericardium and less frequently in organs such as lung, spleen [4], pancreas [5] and liver [6]. In fact, few cases of intrapulmonary malignant mesothelioma have been described [2,3,7,8] presenting with bilateral miliary pulmonary nodules and diffuse bilateral opacities or characterized by diffuse intrapulmonary growth, among which some cases [7,8] were pathologically con irmed as intrapulmonary metastases from a clinically undetectable pleural mesothelioma, while the others [2,3] were diagnosed as diffuse intrapulmonary malignant mesothelioma.…”