MULTIPLE SKELETAL-MUSCLE METASTASES FROM MALIGNANT PLEURAL MESOTHELIOMA

A 54-year-old male patient (occupational asbestos exposure over 27 yea rs) died 2 years and 4 months after the diagnosis of malignant pleural mesothelioma of the right side, despite twice undergoing pleurectomy and radiotherapy. The autopsy revealed a locally advanced pleural meso thelioma of both sides involving the pericardium, heart, right diaphra gm, liver and peritoneum. Disseminated metastases in numerous lymph no des and a hematogenous metastatic spread into both lungs, the thyroid gland, peritoneum and skeletal musculature were found. The left tempor al muscle and proximal limb skeletal muscles of the right upper arm an d both thighs exhibited multiple metastases measuring up to 7 cm in di ameter. Microscopically, a biphasic type of mesothelioma was detected. To our knowledge this is the first extensive case report on muscle me tastases in malignant mesothelioma. Reviewing the literature, it is th ought that in the presented case the long survival time of the patient and his protracted preterminal immobility could have contributed to t he unusual formation of multiple skeletal muscle metastases.