Hayat Redwan, Ahmed Saad, Badiger Rekha, Lee Shi Han, Peryt Adam, Gilligan David, Khalid Zubair
General Practice, Broomfield Hospital, Chelmsford, UK.
Acute Medicine, Colchester General Hospital, Colchester, UK.
Oxf Med Case Reports. 2023 May 30;2023(5):omac151. doi: 10.1093/omcr/omac151. eCollection 2023 May.
This case report explores a 34-year-old male diagnosed with mesothelioma who had no known risk factors. The patient initially was treated for empyema with antibiotics but later represented to hospital with worsening symptoms. He underwent a surgical Video-assisted thoracoscopic surgery procedure and lung biopsy, which revealed a diagnosis of mesothelioma. The young age of the patient as well as absence of significant risk factors for mesothelioma made the diagnosis unexpected. The patient had total body irradiation (TBI) therapy for leukaemia as a child, which increases the risk of developing cancer. However, there are limited studies exploring the risk of pleural mesothelioma post-TBI. Young patients who represent to hospital, with limited response to initial treatment, and suspicious radiological features should be considered for lung biopsy to reduce the risk of a missed diagnosis. Patients with a background of TBI should also be considered for follow-up to monitor for any subsequent malignancy.
本病例报告探讨了一名34岁被诊断为间皮瘤的男性，他没有已知的风险因素。该患者最初因脓胸接受抗生素治疗，但后来因症状恶化再次入院。他接受了电视辅助胸腔镜手术和肺活检，结果显示为间皮瘤。患者的年轻以及缺乏间皮瘤的显著风险因素使得该诊断出乎意料。该患者小时候因白血病接受过全身照射（TBI）治疗，这增加了患癌风险。然而，探索TBI后发生胸膜间皮瘤风险的研究有限。对于入院、初始治疗反应有限且有可疑放射学特征的年轻患者，应考虑进行肺活检以降低漏诊风险。有TBI背景的患者也应考虑进行随访，以监测是否有任何后续恶性肿瘤。
