AI Article Synopsis
- A 66-year-old man with a history of asbestos exposure presented with cough and sore throat, leading to the discovery of pleural effusion and nodules in his lungs via imaging.
- Following surgery for a 3-cm renal tumor, he was diagnosed with renal cell carcinoma, but a pleural biopsy revealed malignant pleural mesothelioma.
- This rare case links asbestos exposure to both types of cancer and highlights the rising incidence of malignant mesothelioma, particularly in industrialized nations, with this being only the second reported case in Japan.
Article Abstract
A 66-year-old man visited complaining of cough and sore throat. He had been exposed to asbestos 43 years ago. Chest X-ray revealed left pleural effusion and abnormal shadow in the right lung field. Chest computed tomography (CT) showed multiple enhanced nodules in the right pleural cavity. Abdominal CT showed a 3-cm enhanced tumor in the lower pole of the left kidney. Left radical nephrectomy was performed. Pathological diagnosis was renal cell carcinoma. Postoperatively pleural biopsy was performed by using thoracoscopy. White plaque was seen at the costal pleura and surface of lung. Pathological diagnosis was malignant pleural mesothelioma based on using mesothelium-associated antibodies: calretinin (+), CK5/6 (+), D2-40 (+), HBME-1 (+), TTF-1 (-), MOC31 (-), CEA (-). Combination therapy (extrapleural pneumonectomy, chemotherapy, and radiotherapy) was initiated. Malignant mesothelioma is a devastating neoplasm with a strong etiological relationship with asbestos exposure. The incidence is rising in industrialized countries, with the peak expected in the year 2020. However, renal cell carcinoma with malignant pleural mesothelioma is very rare and this is the 2nd case in the Japanese literature.
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