Purpose Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. We describe a case of MPM with an uncommon onset, characterized by pseudoachalasia as demonstrated with high-resolution manometry (HRM). Methods A 56-year-old man was referred to our hospital reporting worsening dysphagia. On the hypothesis of an esophageal motor disorder, the patient was referred for an HRM examination, which revealed features consistent with a diagnosis of type II achalasia. Results At the time of the first pneumatic dilation the endoscopist stopped the procedure in order to prevent perforation when he noticed only partial expansion of the pneumatic balloon. A CT scan and subsequent CT-guided excisional biopsy revealed an epithelioid pleural mesothelioma infiltrating the muscle wall. Given his good clinical condition, the patient was eligible for chemotherapy with cisplatin 75 mg/m2 and pemetrexed 500 mg/m2, resulting in a good response with partial remission of the disease and resolution of the dysphagia symptoms. Conclusions Pseudoachalasia as the first or only manifestation of mesothelioma is a rare occurrence that may expose patients to the risk of diagnostic delay. Close attention should be paid whenever a patient with symptoms and signs consistent with achalasia shows unusual features.
A case of pseudoachalasia hiding a malignant pleural mesothelioma / F. Branchi, A. Tenca, C. Bareggi, C. Mensi, A. Mauro, D. Conte, R. Penagini. - In: TUMORI. - ISSN 0300-8916. - 102(2016 Nov), pp. S50-S53.
|Titolo:||A case of pseudoachalasia hiding a malignant pleural mesothelioma|
BRANCHI, FEDERICA (Primo)
TENCA, ANDREA (Secondo)
CONTE, DARIO (Penultimo)
PENAGINI, ROBERTO (Ultimo)
|Parole Chiave:||achalasia; mesothelioma; pseudoachalasia; high-resolution manometry|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||nov-2016|
|Data ahead of print / Data di stampa:||2-lug-2016|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.5301/tj.5000521|
|Appare nelle tipologie:||01 - Articolo su periodico|