DOI: 10.36347/sjmcr.2014.v02i08.005

Pages: 518-520

Papillary mesothelioma of pleura is a rarely observed well-differentiated subtype of epithelial mesothelioma which is a less aggressive, slow growing cancer that does not typically metastasize (spread) to other parts of the body. We report a 55 year old male, farmer by occupation, presented with complaints of breathlessness, cough with expectoration, left-sided chest pain and generalized weakness for 3 months with no history of asbestos exposure nor any lung disease in family. On systemic examination there was restricted chest wall movement on left side with left side bulging of chest, there was decreased breath sounds and presence of stony dullness. Chest X-ray and CT chest revealed left-sided massive pleural effusion. Thoracoscopy guided pleural biopsy was taken which confirmed the diagnosis of papillary mesothelioma.Papillary mesothelioma is well described in the literature, with most reported cases arising from the peritoneum in women of reproductive age. Although less common, doctors have found papillary mesothelioma growth on several of the body’s protective membranes, including the linings of the lungs (pleura), heart (pericardium) and testicles (tunica vaginalis). Unlike malignant mesotheliomas, which are typically associated with asbestos exposure, there is no conclusive evidence linking papillary mesothelioma to asbestos exposure. We conclude that papillary mesothelioma is a rare and unusual mesothelial tumor, characterized by a no evident linkage with asbestos exposure, lack of deep invasion and associated with an indolent clinical course, better prognosis with absence of metastasis and long survival.