Noda Ryuichi, Yanagisawa Shunsuke, Inoue Masato, Hara Tetsuo
Department of Neurosurgery, Center Hospital of the National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.
Department of Neurosurgery, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan; and.
J Neurosurg Case Lessons. 2021 Jan 18;1(3):CASE2099. doi: 10.3171/CASE2099.
Malignant pleural mesothelioma (MPM) is a rare cancer, and in 80% of cases the cause is asbestos exposure. In 1972, the World Health Organization (WHO) declared asbestos is a carcinogenic substance. Since then, every developed country has restricted and banned the product. Because of its high heat resistance, asbestos had been widely used as building material for decades. The WHO estimated that approximately 125 million people are exposed to asbestos, and more than 107,000 die from asbestos-related diseases annually. Because of its long incubation period, the number of patients is estimated to keep increasing in the near future.
The authors report a case of long-surviving MPM with a rushed clinical course after brain metastasis. A 69-year-old woman diagnosed with MPM (epithelial type) 6 years earlier presented with a brain metastasis. The pathological result of the brain metastasis was the sarcomatoid type. This case showed the possibility of subtype transition after long survival.
This article aids in understanding the long-term natural history of MPM and the possibility of epithelial-mesenchymal transition. Neurosurgeons have to be aware of its the natural history and the possibility of brain metastasis.
恶性胸膜间皮瘤（MPM）是一种罕见癌症，80%的病例病因是接触石棉。1972年，世界卫生组织（WHO）宣布石棉是一种致癌物质。自那时起，每个发达国家都对该产品进行了限制和禁用。由于其高耐热性，石棉曾在数十年间被广泛用作建筑材料。WHO估计约有1.25亿人接触过石棉，每年有超过10.7万人死于石棉相关疾病。由于其潜伏期长，预计患者数量在不久的将来会持续增加。
作者报告了一例脑转移后临床病程急促但存活时间长的MPM病例。一名69岁女性6年前被诊断为MPM（上皮型），现出现脑转移。脑转移的病理结果为肉瘤样型。该病例显示了长期存活后亚型转变的可能性。
本文有助于理解MPM的长期自然病程以及上皮-间质转化的可能性。神经外科医生必须了解其自然病程以及脑转移的可能性。
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