Malignant mesothelioma with bone metastases

Abstract

Malignant mesothelioma has rarely been reported to metastasize to bone. This is a report of a 71-year-old man who presented with pleural mesothelioma. After a course of chemotherapy, the patient developed lower back pain. Plain X-ray and bone scan were negative for metastases, but magnetic resonance imaging (MRI) revealed multiple metastatic lesions to the thoracolumbar vertebrae. Subsequent lumbar spine biopsy confirmed the presence of malignant mesothelioma. The patient then received radiation therapy. This report illustrates an unusual presentation for malignant mesothelioma and shows that, in addition, when bone metastases are clinically suspected, MRI may be a useful adjunct to more conventional imaging approach.

Intramedullary metastasis to the cervical spinal cord from malignant pleural mesothelioma: Review of the literature and case reports

“…Overhauling our analysis [Tables 1 and 2], spinal involvement of a malignant PMM is in general exceptional and occurs most commonly as involvement of the vertebral body or epidural space. [3,11,27,33,37,38] Spinal metastasis can be considered as a direct centrifugal extension into the nerve root through the intervertebral foramen, or as a result of hematogenous spread to the meninges through the intercostal arteries or the veins of Batson's plexus. [21,28,30] A characteristic way of spreading is perineural or "neurotropic" growth along nerve roots due to primary tumors neurotropism.…”

Pelvic and Lumbar Metastasis Detected by Bone Scintigraphy in Malignant Pleural Mesothelioma

“…An other series, however, reported "bone involvement beyond the chest" in 7.4%, although no further details were presented (1). Only two well documented case reports of distal osseous metastasis from mesothelioma have been published that describe the radiographic findings (14,15). In one case, a patient had a false-positive bone scan before the lesion eventually was identified with an NMR scan.…”

I feel it in my bones: a rare presentation of idiopathic sclerosing orbital inflammation with hyperostosis

“…1,2 Although ISOI is thought to be limited to the orbit, extraorbital extension and other associated fibrosclerosis disorders have been reported. 4 The direct correlation of hyperostosis relating to malignancy was not convincing, and the likely cause for bone growth would be inflammation related to ISOI. 1 On imaging, sclerosing inflammation of the orbit generally appears as a homogeneously enhancing soft tissue lesion with irregular yet distinct borders.…”