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Tumor Discovery

CASE REPORT
Sarcomatoid mesothelioma presenting as a

mediastinal mass: A case report

Elizabeth Chiang * , Neda Zarrin-Khameh 2 , and Alec B. Rezigh 3
1
1 Department of Medicine, School of Medicine, Baylor College of Medicine, Houston, Texas,
United States of America
2 Department of Pathology and Immunology, Baylor College of Medicine and Ben Taub Hospital,
Houston, Texas, United States of America
3 Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
(This article belongs to the Special Issue: New Developments in Lung Cancer Research, Diagnosis,
Treatment, and Prognosis)

Abstract

Sarcomatoid mesothelioma (SM) is a subtype of mesothelioma, a deadly cancer
strongly related to asbestos exposure. Herein, we present the case of a 50-year-old
female who presented with back pain and non-specific symptoms for approximately
9 months. The diagnostic investigation revealed a large, centrally necrotic mass in the
thorax that appeared to arise from the mediastinum and surrounded vital structures,
including the superior vena cava. A biopsy of the thoracic mass revealed SM. The
patient developed hematemesis, and emergent endoscopy revealed a gastric ulcer
composed of malignant SM cells, a rare finding in pleural mesothelioma. Her disease
was too advanced for surgical resection and conventional therapy. She tragically died
weeks after diagnosis. The findings of this report highlight the varied presentation
*Corresponding author:
Elizabeth Chiang of SM to underscore the importance of early diagnosis and treatment of patients in
(elizabeth.chiang@bcm.edu) improving overall survival.
Citation: Chiang E, Zarrin-
Khameh N, Rezigh AB. Keywords: Mediastinal mass; Dyspnea; Back pain; Sarcomatoid mesothelioma; Lung
Sarcomatoid mesothelioma
presenting as a mediastinal mass: cancer
A case report. Tumor Discov.
2024;3(4):4420.
doi: 10.36922/td.4420
Received: August 2, 2024 1. Introduction
Accepted: September 25, 2024 Sarcomatoid mesothelioma (SM) is a subtype of mesothelioma, a rare cancer arising
Published Online: October 10, 2024 from mesothelial surfaces of tissues – most commonly the pleura – and is directly
related to asbestos exposure. Asbestos-related diseases have long latency periods, so
1
Copyright: © 2024 Author(s).
This is an Open-Access article consequences of exposure tend to be detectable approximately 40 years after initial
distributed under the terms of the contact. Due to this, many patients first present in their fifth or sixth decades of life with
Creative Commons Attribution late-stage disease, often with signs of progressing respiratory failure, making treatment
License, permitting distribution,
2,3
and reproduction in any medium, challenging. Mesothelioma is classified into three main subtypes based on histology:
provided the original work is epithelioid, sarcomatoid, and biphasic. SM is the least common but most aggressive of
properly cited. these classes, with the lowest median survival time of approximately 3.5 – 7.4 months. 2,4,5
Publisher’s Note: AccScience Herein, we report a case of advanced SM with an atypical presentation due to a heavy
Publishing remains neutral with burden of locally invasive disease and extrathoracic metastases. This case report aims to
regard to jurisdictional claims in
published maps and institutional highlight the importance of early diagnosis and treatment in patients with SM with the
affiliations. aim of improving their overall survival.

Volume 3 Issue 4 (2024) 1 doi: 10.36922/td.4420