# Spindle Cell Malignancy and Asbestos Exposure: A Case Report

## TL;DR

A 68-year-old woman with a history of asbestos exposure was diagnosed with a rare spindle cell sarcoma, highlighting the importance of individualized screening.

## Contribution

This case report presents a rare spindle cell malignancy associated with asbestos exposure and emphasizes personalized screening approaches.

## Key findings

- A left-sided pleural effusion led to the discovery of a spindle cell sarcoma.
- The patient had a long history of occupational asbestos exposure.
- The case underscores the need for individualized, shared decision-making in screening.

## Abstract

We outline the presentation of a 68-year-old woman who received a chest radiograph due to her insurance requirements, resulting in the discovery of a left-sided pleural effusion. The effusion was further characterized as loculated on subsequent imaging. Thoracentesis yielded exudative fluid, leading to the patient undergoing video-assisted thoracoscopic surgery (VATS). During this procedure, a cystic mass was visualized, with the conversion of the operation to an open thoracotomy and left lower lobe lobectomy. Pathology was positive for spindle cell sarcoma. A thorough history of the patient revealed a decades-long occupational exposure to asbestos. The significance of this report is to illustrate the clinical presentation, immunohistochemical characteristics, and management of a rare spindle cell malignancy. Our case also raises the importance of screening patients on an individualized, shared decision-making basis.