A Rare Case of Sarcomatoid-Type Localized Pleural Mesothelioma Derived From Visceral Pleura

A man in his 80s presented with shortness of breath. Chest CT scan showed pleural effusion and a mass in the right lower lobe. He had high inflammatory reaction and was diagnosed as having pulmonary suppuration with empyema. After three weeks of antibiotic treatment, the lesion grew and he was referred to our department for surgical intervention. A complete resection of the right lower lobe was planned to control infection. Intraoperative findings showed that the lower lobe became a large mass and was judged unresectable. The procedure was converted to drainage of the abscess cavity. Pathological examination, combined with clinical and radiological findings, led to the diagnosis of localized sarcoma-type malignant pleural mesothelioma. Localized malignant pleural mesothelioma is a rare disease and most cases have been reported as epithelial type, deriving from the parietal pleura. Our case is quite rare because it was a sarcoma-type, deriving from the visceral pleura.