Grellner W, Staak M
Institute of Forensic Medicine, University of Cologne, Germany.
Pathol Res Pract. 1995 Jun;191(5):456-60; discussion 461-2. doi: 10.1016/S0344-0338(11)80732-6.
A 54-year-old male patient (occupational asbestos exposure over 27 years) died 2 years and 4 months after the diagnosis of malignant pleural mesothelioma of the right side, despite twice undergoing pleurectomy and radiotherapy. The autopsy revealed a locally advanced pleural mesothelioma of both sides involving the pericardium, heart, right diaphragm, liver and peritoneum. Disseminated metastases in numerous lymph nodes and a hematogenous metastatic spread into both lungs, the thyroid gland, peritoneum and skeletal musculature were found. The left temporal muscle and proximal limb skeletal muscles of the right upper arm and both thighs exhibited multiple metastases measuring up to 7 cm in diameter. Microscopically, a biphasic type of mesothelioma was detected. To our knowledge this is the first extensive case report on muscle metastases in malignant mesothelioma. Reviewing the literature, it is thought that in the presented case the long survival time of the patient and his protracted preterminal immobility could have contributed to the unusual formation of multiple skeletal muscle metastases.
一名54岁男性患者（职业性接触石棉超过27年），在被诊断为右侧恶性胸膜间皮瘤2年零4个月后死亡，尽管接受了两次胸膜切除术和放射治疗。尸检显示双侧局部晚期胸膜间皮瘤，累及心包、心脏、右侧膈肌、肝脏和腹膜。发现多个淋巴结有弥漫性转移，血行转移至双肺、甲状腺、腹膜和骨骼肌。左颞肌以及右上臂和双侧大腿的近端肢体骨骼肌出现多个直径达7厘米的转移灶。显微镜下检测到双向型间皮瘤。据我们所知，这是首例关于恶性间皮瘤肌肉转移的广泛病例报告。回顾文献，认为在本病例中，患者较长的生存时间以及临终前长期的行动不便可能促成了多处骨骼肌转移这种不寻常情况的形成。
