73-year-old male ex-smoker who presented with dyspnea, cough and a large left side pleural effusion, thoracentesis drained an exudative fluid with atypical mesothelial cells on cytology. We performed thoracoscopy with pleural biopsy, pathology showed malignant mesothelioma, epithelioid type. He underwent thoracotomy with extended pleurectomy decortication and reconstruction of the diaphragm, pathology revealed mesothelioma with mixed epithelioid and sarcomatoid disease.
Patient received adjuvant chemotherapy (carboplatin and pemetrexed), followed by immunotherapy due to concern of possible growing area of pleural thickening.
Patient continues to do well two years following his surgery.
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