Malignant Pleural Mesothelioma Presenting with Prolonged Fever and Rapid-Growing Pleural Mass-A Case Report

惡性肋膜間皮瘤是個不常見卻又不再罕見的癌症。常見的表現包括有胸痛、呼吸困難、及肋膜積水。但發燒並不是惡性肋膜間皮瘤的典型臨床表現。一般來說有幾種方法可以用來評估肋膜腔積液：包括肋膜腔液抽吸細胞學檢查、肋膜切片、經皮電腦斷層導引下肋膜切片以及胸腔鏡切片。本例我們報告一位29歲男性病例以左側肋膜積液合併發燒及左側胸痛來表現。經過細針抽吸及肋膜切片皆無確切診斷，之後接受胸腔鏡切片描述為慢性發炎組織以及創傷後造成的血腫。一個月後，該病例仍因持續發燒以及全身倦怠合併喘的情形再次進行評估，再一次的胸腔鏡切片證實為惡性肋膜間皮瘤。經過左側全肺切除，局部放射線治療及化學治療後，該病例在五個月後因全身多處轉移死亡。因此當臨床表現為發燒及快速生長之肋膜腫瘤時，惡性肋膜間皮瘤是需要被考慮的診斷之一。因為其癒後極差，因此正確且即時的診斷更形重要。

關鍵字

惡性肋膜間皮瘤；發燒；快速生長之肋膜腫瘤；胸腔鏡切片

並列摘要

Malignant pleural mesothelioma (MPM) is an uncommon, but no longer rare cancer. The most common symptoms include dyspnea, chest pain, and unilateral pleural effusion. However, prolonged fever has not been mentioned in published reports. There are several diagnostic means of evaluating pleural effusion, including effusion cytology, pleural biopsies, percutaneous computed tomography (CT)-guided cutting biopsy, and thoracoscopic biopsy. We report a 29-year-old male patient who developed left-side pleural effusion and prolonged fever without an accurate diagnosis until repeated thoracoscopic biopsies were done. MPM was diagnosed, and spread rapidly within 1 month. He died of multiple metastasis 5 months after diagnosis and left pneumonectomy. To the best of our knowledge, this may be the first report of MPM mainly presenting with prolonged fever and a rapidly-growing pleural mass. Hence, mesothelioma should be considered when fever and a rapidly-growing pleural mass occur simultaneously.

並列關鍵字

malignant pleural mesothelioma ； prolonged fever ； rapid-growing pleural mass ； thoracoscopic biopsy

國際替代計量

Malignant Pleural Mesothelioma Presenting with Prolonged Fever and Rapid-Growing Pleural Mass-A Case Report

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