Cerebellum, Metastatic malignant mesothelioma [LMP53348]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Metastatic malignant mesothelioma
Species: 
Human
Organ System: 
Central Nervous System
Gender: 
Male
Age: 
55 years
Diagnosis Code: 
ICD-10: C79.3 | ICD-O: 9050/3
Slide Contributor Information
Gao, A., Keith, J.

Keywords

Malignant mesothelioma, mesothelium, brain metastasis

Clinical History

55-year-old man with headache. Neuroimaging shows a mass in the cerebellum. The patient also has a large pleural mass.

Clinical Discussion

Malignant mesothelioma is a rare, aggressive neoplasm of serosal surfaces closely linked to asbestos exposure. Most often a locally invasive tumour, distant metastasis can also occur. However, in most published series, intracranial metastasis is very rare, occurring in less than 3% of cases. Microscopically, mesothelioma may show a variety of morphologies, the most common being epithelioid (as in this case), spindled/sarcomatoid, or biphasic. All histologic subtypes have been reported to metastasize to the CNS, with the most common being sarcomatoid. Immunohistochemistry for mesothelial markers (e.g. WT1, calretinin) and CK5/6 helps to distinguish metastatic mesothelioma from adenocarcinoma. Prognosis of CNS mesothelioma is very poor since it often represents a late finding.