# Challenging the Norm: Occurrence of Synchronous Pleural and Peritoneal Mesothelioma in a Female Patient

## TL;DR

A woman in her 40s developed both pleural and peritoneal mesothelioma without asbestos exposure, highlighting the need for thorough diagnosis of pleural effusion.

## Contribution

Reports a rare case of synchronous mesothelioma in a female without asbestos exposure.

## Key findings

- Patient presented with synchronous pleural and peritoneal mesothelioma.
- Diagnosis confirmed via thoracoscopy and immunohistochemical staining.
- Case highlights the importance of aggressive evaluation for rare causes of pleural effusion.

## Abstract

Here, we present a unique case involving a female patient in her 40s with synchronous malignant pleural and peritoneal mesothelioma, despite lacking a history of asbestos exposure. The patient's initial symptoms included dyspnoea, chest pain, cough, fever, appetite loss, and weight loss over a month. Clinical evaluation led to the identification of right-sided pleural effusion, prompting consideration of differential diagnoses, such as tubercular or malignant pleural effusion. A thoracoscopy-guided biopsy, followed by histopathological examination and immunohistochemical staining, confirmed the diagnosis of mesothelioma. Chemotherapy was initiated as part of the treatment plan. The prognosis for this condition is generally bad; however, unusual cases of extended survival have been documented. The complexities of our case underscore the critical necessity for a thorough and aggressive evaluation of pleural effusion cases to unveil rare underlying causes, such as mesothelioma.