An 86-year-old man presented with bilateral lower limb edema and was found to have hydropneumothorax on chest radiography. CT revealed a substantial pleural effusion and plaques. The patient had a history of working in a stone workshop, but the extent of asbestos exposure remained unknown. Thoracic drainage and subsequent thoracoscopic surgery confirmed the presence of biphasic malignant mesothelioma through pathological examination. Hydropneumothorax as a presentation of malignant pleural mesothelioma (MPM) is rare, with only a few similar cases reported. Remarkably, despite the coexistence of plural effusion and pneumothorax, the patient did not experience dyspnea. The examination also revealed tumor rupture and disruption of the pleura. Considering the possibility of MPM in patients with asymptomatic hydropneumothorax is essential for early diagnosis and appropriate management.
Malignant pleural mesothelioma (MPM) is an aggressive tumor originating from the mesothelial cells lining the pleural cavity and is commonly associated with asbestos exposure. Typically, MPM manifests with symptoms such as dyspnea, cough, and chest pain, while hydropneumothorax is an infrequent finding for its detection. Limited reports have described cases of MPM presenting with hydropneumothorax. This report presents a similar case and discusses the distinctive clinical characteristics. Despite the presence of pleural effusion and pneumothorax, the patient remained asymptomatic. This article explores the pathogenesis, challenges in diagnosis, and the importance of considering MPM in cases of asymptomatic hydropneumothorax. Early detection and comprehensive evaluation are critical for effectively managing this uncommon presentation of MPM.[Article continues at original source]
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