Malignant pleural mesothelioma presenting as spontaneous pneumothorax: A case series and review

Background Malignant pleural mesothelioma (MPM) is thought to arise from th e mesothelial cells that line the pleural cavities. Most patients initially ?, experience the insidious onset of chest pain or shortness of breath, and it rarely presents as spontaneous pneumothorax. Case reports We report four patients who presented in this manner. Three of the patients,were exposed to asbestos directly at indirectly at shipyards during World War II; the fourth was exposed as an insulators wife. Two of o ur cases were not recognized to have MPM on histologic examination at first thoracotomy and remained asymptomatic for 12 and 22 months, respectively, In none of the patients described herein, was spontaneous pneumothorax the cause of death, Conclusion Since many people were exposed to asbestos during and after Worl d War II, spontaneous pneumothorax in a patient with the possibility of suc h exposure should raise the suspicion of malignant pleural mesothelioma. (C ) 2000 Wiley-Liss, Inc.