A Rare Clinical Presentation of Malignant Pleural Mesothelioma With Central Nervous System Metastases: A Case Report

TL;DR

A 63-year-old woman with malignant pleural mesothelioma developed rare central nervous system metastases, showing the aggressive and challenging nature of the disease.

Contribution

This case report presents an unusual clinical presentation of MPM with CNS metastases in a female patient.

Findings

The patient showed a partial response to cisplatin and pemetrexed chemotherapy.

CNS metastases were detected months after treatment completion.

Palliative radiotherapy provided only temporary control of neurological symptoms.

Abstract

Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer arising from the pleural mesothelial cells, most often associated with long-term asbestos exposure. Symptoms are typically nonspecific, including shortness of breath, chest pain, and pleural effusion, which may delay diagnosis. We report a case of a 63-year-old woman with bilateral MPM and subsequent central nervous system (CNS) metastases. She received systemic chemotherapy with cisplatin and pemetrexed, achieving a partial radiological response. Several months after completing treatment, she developed neurological symptoms. Imaging revealed multiple CNS metastases. Palliative radiotherapy provided temporary control; however, her condition progressively deteriorated. This case illustrates an unusual presentation and metastatic pattern of MPM in a female patient, highlighting diagnostic and therapeutic challenges, as well as the aggressive nature of the disease despite palliative care.