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conferenceseries
.com
Volume 3
October 03-04, 2018 Osaka, Japan
Pediatric Neurology & Medicine
3
rd
International conference on
N
euroscience
, N
euroradiology
and
I
maging
Neuroimaging 2018
October 03-04, 2018
J Pediatr Neurol Med 2018, Volume 3
DOI: 10.4172/2472-100X-C1-003
Rare metastatic behavior of biphasic pleural mesothelioma
Pritesh Pranay
1
, Victor Serafimov
2
, Julia Hall
3
and Amit Goel
3
1
NHS Frimley Health Foundation Trust, UK
2
Dartford and Gravesham NHS Trust, UK
3
Maidstone and Tunbridge Wells NHS Trust, UK
A
Caucasian gentleman (known asbestos exposure with related pleural changes managed by watchful wait since 2010) was
admitted with a 12-week history of reduced sensation in his left leg, back pain, reduced sensation opening his bowels and
some difficulty walking reduced proprioception in his leg. This case highlights the variability of clinical presentation given
metastatic pleural mesothelioma. Mesothelioma is an uncommon tumor of pleural mesothelioma with a prediction for local
invasion. CNS metastasis is rare, particularly intramedullary compression of spinal cord has been seen but remains a rare
occurrence and has only been reported merely 8 times. It offers an insight to clinicians to be aware of malignant metastatic
mesothelioma as a differential diagnosis is primary cord lesion by taking the relevant clinical history into account. CT chest,
abdomen and pelvis with IV contrast performed in June 2016 showed significant size increase of the right pleural disease with
disease tapering into the T2/T3 left lateral foramen, which appears obliterated by enhancing mass and loss of the cortical line
in the anterior wall of the bony foramen (all this was normal on the previous CT chest, abdomen and pelvis with IV contrast in
2015. There is also new disease on the right chest lower zone affecting the medial and dorsal pleura over the medial and dorsal
right lung lower lobe segments. MRI whole spine on the same day of admission showed 23 mm long intramedullary metastasis
at T2/T3 level with extensive adjacent cord edema from Upper C6 till T6 and further bony deposit of T8. Biopsy taken under
ultrasound from pleural mass tapering into left T3/T4 lateral foramen showed fragments of thickened fibrotic pleura with a
biphasic tumor composed of epithelioid and spindle cells. Immunostaining confirmed a biphasic malignant mesothelioma
with the tumor cells positive for MNF116 and EMA with focal positivity for CK 5/6 and few cells positive for WT -1, the
latter two being mesothelial markers. The tumor was negative for p63, calretinin, desmin, CD34 and TTF-1. Mib-1 showed a
proliferative index of about 30%.
rapidpriteshz@gmail.com