Brain metastasis of a malignant pleural mesothelioma: A case report and review of the literature

Background: The present report documents the case of a patient with a rare malignant pleural mesothelioma (MPM) that metastasized intracranially who survived 8 months following diagnosis. We compared the patient's clinical course to the clinical characteristics of twelve other patients who survived longer than six months through a review of the literature. Case description: A 58-year-old man presented to our hospital with memory disturbance, headache, and language problems developed 15 days prior to his admission. Brain magnetic resonance imaging showed a single enhanced mass lesion in the left temporo-occipital lobe. Biopsy of the pleural mass demonstrated a suspicious sarcomatoid mesothelioma. The removal of the intracranial mass improved his symptoms. Pathological examination of the brain mass confirmed sarcomatoid mesothelioma. The patient underwent radiotherapy and chemotherapy, but the lung lesion demonstrated no changes in the five and a half months following the operation. Stereotactic radiosurgery was performed to address the recurrent brain mass six months after the operation. He died eight months after the initial surgery. Eleven of the 12 similar cases found in the literature reported aggressive treatment of the brain metastasis. Conclusion: Intracranial metastasis of MPM should be treated aggressively in the case of a stable primary lesion.