Journal of Neuro-Oncology

, Volume 17, Issue 1, pp 21–26 | Cite as

Cerebral metastases in pleural mesothelioma: Case report and review of the literature

  • Marek Wroński
  • Michael Burt
Clinical Study


A case of malignant mesothelioma metastatic to the brain is described. A 52-year old woman, with no known exposure to asbestos, presented with a biphasic mesothelioma of the left parietal pleura. Following resection, the thorax was irradiated with 4000 cGy, and all symptoms subsided. Three months later, a left temporal lobe tumor was diagnosed and subsequently resected. Despite neurological improvement, she died 10 days postoperatively from constrictive pericardial disease. The authors have reviewed the 54 reported cases of brain metastases from mesothelioma and have noted that the histologic appearance of brain metastases from mesothelioma may be similar to glioblastoma multiforme. Because brain metastasis from mesothelioma is rare, procedures to clarify the nature of the tumor should be performed.

Key words

malignant mesothelioma brain metastases neoplasm 


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  1. 1.
    Weiss RB, Muggia FM: Working conference on mesothelioma treatment trials. Cancer Res 33: 3799–3800, 1979Google Scholar
  2. 2.
    McDonald AD, McDonald JC: Epidemiology of malignant mesothelioma. In: Antman K, Aisner J (eds) Asbestos Related Malignancy, Grune & Straton, Orlando, 31–55, 1987Google Scholar
  3. 3.
    Wagner JC, Sleggs CA, Marchand D: Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province. Br J Industr Med 17: 260–271, 1960Google Scholar
  4. 4.
    Selikoff IJ, Hammond EC, Seidman H: Mortality experience of insulation workers in the United States and Canada, 1943–76. Ann NY Acad Sci 25: 409–425, 1979Google Scholar
  5. 5.
    Hogan MD, Hoel DG: Estimated cancer risk associated with occupational asbestos exposure. Risk Analysis 1: 67–76, 1981Google Scholar
  6. 6.
    Chaileux E, Daubouis G, Pioche D, de Lajarte M, de Lajarte AY, Rembeaux A,et al.: Prognostic factors in diffuse malignant pleural mesothelioma. A study of 167 patients. Chest 93: 159–162, 1988PubMedGoogle Scholar
  7. 7.
    Elmes PC, Simpson MJC: The clinical aspects of mesothelioma. Q J Med 45: 421–449, 1976PubMedGoogle Scholar
  8. 8.
    Law MR, Hodson ME, Turner-Warwick M: Malignant mesothelioma of the pleura: clinical aspects and symptomatic treatment. Eur J Respir Dis 65: 162–168, 1984PubMedGoogle Scholar
  9. 9.
    Solomons K: Malignant mesothelioma — clinical and epidemiological features. A report of 80 cases. S Afr Med J 66: 407–412, 1984PubMedGoogle Scholar
  10. 10.
    Roberts GH: Distant visceral metastases in pleural mesothelioma. Br J Dis Chest 70: 246–250, 1976PubMedGoogle Scholar
  11. 11.
    Huncharek M, Muscat J: Metastases in diffuse pleural mesothelioma: influence of histological type. Thorax 42: 897–898, 1987PubMedGoogle Scholar
  12. 12.
    Vertun-Baranowska B, Szymanska D, Szturmowicz M: Malignant mesothelioma in the material of the Institute of Tuberculosis in Warsaw. Part I. Evaluation of autopsy material, (in Polish) Pneum Pol 57: 47–54, 1988Google Scholar
  13. 13.
    Borow M, Conston A, Livornese L, Schalet N: Mesothelioma following exposure to asbestos: a review of 72 cases. Chest 64: 641–646, 1973PubMedGoogle Scholar
  14. 14.
    Antman KH, Blum RH, Greenberger JS, Flowerdew G, Skarin AT, Canellos GP: Multimodality therapy for malignant mesothelioma based on a study of natural history. Am J Med 68: 356–362, 1980PubMedGoogle Scholar
  15. 15.
    DaValle MJ, Faber LP, Kittle CF, Jensik RJ: Extrapleural pneumonectorny for diffuse, malignant mesothelioma. Ann Thorac Surg 42: 612–618, 1986PubMedGoogle Scholar
  16. 16.
    McCormack PM, Nagasaki F, Hilaris BS, Martini N: Surgical treatment of pleural mesothelioma. J Thorac Cardiovasc Surg 84: 834–842, 1982PubMedGoogle Scholar
  17. 17.
    Martini N, McCormack PM, Bains MS, Kaiser LR, Burt ME, Hilaris BS: Pleural mesothelioma. Ann Thorac Surg 43: 113–120, 1987PubMedGoogle Scholar
  18. 18.
    Alberts AS, Falkson G, Goedhals L, Vorobiof DA, Van der Merwe CA: Malignant pleural mesothelioma: a disease unaffected by current therapeutic maneuvers. J Clin Oncol 6: 527–535, 1988PubMedGoogle Scholar
  19. 19.
    Grumme von Th, Bingas B: Die intrakranielle Metastasierung des diffusen Pleuramesothelioms. Zbl Neurochir 34: 41–48, 1973Google Scholar
  20. 20.
    Jänisch W, Zimmermann K: Häufigkeit von Metastasen im Zentralnervensystem bei Pleuramesotheliomen ung Lungenkarzinomen. Zbl Neurochir 36: 37–39, 1975Google Scholar
  21. 21.
    Urschel HC, Paulson DP: Mesotheliomas of the pleura. Ann Thorac Surg 1: 559–573, 1965Google Scholar
  22. 22.
    Vogelzang NJ: Malignant mesothelioma: diagnostic and management strategies for 1992. Semin Oncol 19 Suppl 11: 64–71, 1992Google Scholar
  23. 23.
    Martini N, Rusch VW: Comprehensive approach to diagnosis and management of pleural mesothelioma. In: Deslauries J, Lacquet LK (eds) Thoracic Surgery: Surgical Management of Pleural Diseases. CV Mosby Company, St. Louis 311–315, 1990Google Scholar
  24. 24.
    Karakousis CP, Seddiq M, Moore R: Malignant mesotheliomas and chemotherapy. J Surg Oncol 15: 181–185, 1980PubMedGoogle Scholar
  25. 25.
    Gordon W, Antman KH, Greenberger JS, Weichselbaum RR, Chaffey JT: Radiation therapy in the management of patients with mesothelioma. Int J Radiat Oncol Biol Phys 8: 19–25, 1982PubMedGoogle Scholar
  26. 26.
    Hilaris BS, Nori DT, Kwong E, Kutcher GJ: Pleurectomy and intraoperative brachytherapy and postoperative radiation in the treatment of malignant mesothelioma. Int J Radiat Oncol Biol Phys 10: 325–331, 1984PubMedGoogle Scholar
  27. 27.
    Lerner HJ, Schoenfeld DA, Martin A, Falkson G, Borden E: Malignant mesothelioma. The Eastern Cooperative Oncology Group (ECOG) experience. Cancer 52: 1981–1985, 1983PubMedGoogle Scholar
  28. 28.
    Achatzy R, Beba W, Ritschler R, Wörn H, Wahlers B, Macha HN, Morgan JA: The diagnosis, therapy and prognosis of diffuse malignant mesothelioma. Eur J Cardio-thorac Surg 3: 445–448, 1989Google Scholar
  29. 29.
    Vogelzang NJ, Schultz SM, Iannucci AM, Kennedy BJ: Malignant mesothelioma. The University of Minnesota experience. Cancer 53: 377–383, 1984PubMedGoogle Scholar
  30. 30.
    Me Caughey WTE: Criteria for diagnosis of diffuse mesothelial tumors. Ann NY Acad Sci 132: 603–613, 1965PubMedGoogle Scholar
  31. 31.
    Oels HC, Harrison EG, Carr DT, Bernatz PE: Diffuse malignant mesothelioma of the pleura: a review of 37 cases. Chest 60: 564–570, 1971PubMedGoogle Scholar
  32. 32.
    Adams VI, Unni KK: Diffuse malignant mesothelioma of pleura: diagnostic criteria based on an autopsy study. Am J Clin Pathol 82: 15–23, 1984PubMedGoogle Scholar
  33. 33.
    Dejmek A: Bone metastases in malignant mesothelioma are not uncommon. (Letter to the Editor). Ped Oncol 20: 86, 1992Google Scholar
  34. 34.
    Walters KL, Martinez J: Malignant fibrous mesothelioma metastatic to brain and liver. Acta Neuropathol (Berl) 33: 173–177, 1975Google Scholar
  35. 35.
    Schwechheimer K, Butzengeiger M: Brain metastases in malignant fibrous mesothelioma. Case report and review of literature. Acta Neuropathol (Berl) 60: 301–304, 1983Google Scholar
  36. 36.
    Harrison RN: Sarcomatous pleural mesothelioma and cerebral metastases: case report and review of eight cases. Eur J Respir Dis 65: 185–188, 1984PubMedGoogle Scholar
  37. 37.
    Bianchi C, Grandi G, Di Bonito L: Metastasi cerebrali da mesotelioma della pleura. Proceedings XXI Meeting of the Italy-Spain Neuropathologists, Sienna, Italy 29th June-2nd July 1985, p 124Google Scholar
  38. 38.
    Kaye JA, Wang AM, Joachim CL, Seltzer SE, Cibas E, Skarin A,et al.: Malignant mesothelioma with brain metastases. Am J Med 80: 95–97, 1986PubMedGoogle Scholar
  39. 39.
    McNaughton WM, Broughton ME, Toner GC, Schwartz MA: Presentation of malignant pleural mesothelioma with cerebral metastases. J Royal Soc Med 83: 466–467, 1990Google Scholar
  40. 40.
    Asoh Y, Nakamura M, Shiogai T, Ogashiwa M, Takeuchi K, Watanabe K,et al.: Brain metastasis from primary pericardial mesothelioma. Case report. Neurol Med Chir (Tokyo) 30: 884–887, 1990Google Scholar
  41. 41.
    Falconieri G, Grandi G, DiBonito L, Bonifacio-Gori D, Giarelli L: Intracranial metastases from malignant pleural mesothelioma. Report of three autopsy cases and rev iew of literature. Arch Pathol Lab Med 115: 591–595, 1991PubMedGoogle Scholar
  42. 42.
    Henderson DW, Shilkin KB, Whitaker D, Attwood HD, Constance TJ, Steele RH, Leppard PJ: The pathology of malignant mesothelioma, including immunohistology and ultrastructure. In: Henderson DW, Shilkin KB, Langlois S Le P, Whitaker D (eds) Malignant Mesothelioma. Hemisphere Publishing Corporation, New York 127–139, 1992Google Scholar
  43. 43.
    Sridhar KS, Hussein AM, Ganjei P, Thurer RJ, Raskin N, Beattie EJ: Brain metastases in malignant pleural mesothelioma. Case report and review of the literature. Am J Clin Oncol 12: 222–228, 1989PubMedGoogle Scholar
  44. 44.
    Nielsen C, Hansen IM: Sarcomatous mesothelioma of the pleura with cerebral metastases. Med J Austr 153: 625–626, 1990Google Scholar
  45. 45.
    Ball DL, Cruickshank DG: The treatment of malignant mesothelioma of the pleura: Review of a 5-year experience, with special reference to radiotherapy. Am J Clin Oncol 13: 4–9, 1990PubMedGoogle Scholar
  46. 46.
    Huncharek M, Muscat J, Capotorto J: Pleural mesothelioma in a lift mechanic. Br J Ind Med 46: 500–501, 1989PubMedGoogle Scholar
  47. 47.
    Lewis RA: Antemortem recognition of brain metastases in malignant mesothelioma. (Letter) Thorax 45: 983–984, 1990Google Scholar
  48. 48.
    Chahinian AP, Kirschner PA, Gordon RE, Szrajer L, Holland JF: Usefulness of the nude mouse model in mesothelioma based on a direct patient-xenograft comparison. Cancer 68: 558–560, 1991PubMedGoogle Scholar
  49. 49.
    Ratzer ER, Pool JL, Melamed MR: Pleural mesotheliomas. Clinical experiences with thirty-seven patients. J Roentgenol Radium Ther Nucl Med 99: 863–880, 1967Google Scholar
  50. 50.
    Billinghurst JR: Intracranial space-occupying lesions in African patients at Mulago Hospital, Kampala. East African Med J 9: 385–393, 1966Google Scholar
  51. 51.
    Brenner J, Sordillo PP, Magill GB, Golbey RB: Malignant mesothelioma of the pleura. Review of 123 patients. Cancer 49: 2431–2435, 1982PubMedGoogle Scholar
  52. 52.
    Adams VI, Unni KK, Muhm JR, Jett JR, Ilstrup DM, Bernatz PE: Diffuse malignant mesothelioma of pleura. Diagnosis and survival in 92 patients. Cancer 58: 1540–1551, 1986PubMedGoogle Scholar
  53. 53.
    Ruffie P, Feld R, Minkin S, Cormier Y, Boutan-Laroze A, Ginsberg R, Ayoub J, Shepherd FA, Evans WK, Figueredo A, Pater JL, Pringle JF, Kreisman H: Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 322 patients. J Clin Oncol 7: 1157–1168, 1989PubMedGoogle Scholar
  54. 54.
    Schwalbe J: Zür Lehre von den primären Lungen- und Brustfellgeschwülsten. Dtsch Med Wschr 45: 1235–1238, 1891Google Scholar
  55. 55.
    Kay S, Silverberg SA: Ultrastructural studies of a malignant fibrous mesothelioma of the pleura. Arch Pathol 92: 449–455, 1971PubMedGoogle Scholar
  56. 56.
    Mychalczak BR, Nori D, Armstrong JG, Martini N, Harrison LB: Results of treatment of malignant pleural mesothelioma with surgery, brachytherapy, and external beam irradiation. Proc. XIIth Mid-Winter Meeting Am Endocurietherapy Soc, Dec. 6–9, 1989Google Scholar
  57. 57.
    Rusch VW, Piantadosi S, Holmes EC: The role of extrapleural pneumonectomy in malignant pleural mesothelioma. A lung cancer study group trial. J Thorac Cardiovasc Surg 102: 1–9, 1991PubMedGoogle Scholar
  58. 58.
    Wiessmann LB, Antman KH: Incidence, presentation and promising new treatments for malignant mesothelioma. Oncology 3: 67–82, 1989Google Scholar
  59. 59.
    Harwood TR, Grecey DR, Yokoo H: Pseudomesotheliomatous carcinoma of the lung. A variant of peripheral lung carcinoma. Am J Clin Pathol 65: 159–167, 1976PubMedGoogle Scholar
  60. 60.
    Wick MR, Loy T, Mills SE, Legier JF, Manivel JC: Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: A histochemical, ultrastructural, and immunohistologic study of 103 cases. Hum Pathol 21: 759–766, 1990PubMedGoogle Scholar
  61. 61.
    Spirtas R, Keehn RJ, Beebe GW, Wagner JC, Hochholzer L, Davies JNP, Ortega LG, Sherwin RP: Results of a pathology review of recent US mesothelioma cases. Accomplishments in Oncology 1: 144–152, 1986Google Scholar
  62. 62.
    Llewellen MJ, Atkinson MW, Fabri B: Pericardial constriction caused by primary mesothelioma. Br Heart J 57: 54–57, 1987PubMedGoogle Scholar
  63. 63.
    Ginsberg RJ: Diffuse malignant mesothelioma: a therapeutic dilemma. Ann Thorac Surg 42: 608, 1986PubMedGoogle Scholar
  64. 64.
    Lederman GS, Recht A, Herman T, Osteen R, Corson J, Antman KH: Long-term survival in peritoneal mesothelioma. The role of radiotherapy and combined modality treatment. Cancer 59: 1882–1886, 1987PubMedGoogle Scholar
  65. 65.
    Huncharek M: Antemortem recognition of brain metastases in malignant mesothelioma. (Letter) Thorax 45: 984, 1990PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1993

Authors and Affiliations

  • Marek Wroński
    • 1
  • Michael Burt
    • 2
  1. 1.The Department of Anesthesiology Neurosurgery Service of Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Thoracic ServiceMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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