gms | German Medical Science

Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie

24.-26.10.2013, Basel, Schweiz

Simultaneous occurrence of a malignant mesothelioma in the chest wall and in the umbilicus – or metastatic invasion of one another? A case report

Meeting Abstract

  • A. E. Frick - Thoraxchirurgie, Otto Wagner Spital, Wien
  • E. Stubenberger - Thoraxchirurgie, Otto Wagner Spital, Wien
  • M. R. Müller - Thoraxchirurgie, Otto Wagner Spital, Wien
  • M. Hochmaier - Innere Medizin, Otto Wagner Spital, Wien
  • S. B. Watzka - Thoraxchirurgie, Otto Wagner Spital, Wien

Deutsche Gesellschaft für Thoraxchirurgie. Österreichische Gesellschaft für Thoraxchirurgie. Schweizerische Gesellschaft für Thoraxchirurgie. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie. Basel, Schweiz, 24.-26.10.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP47

doi: 10.3205/13dgt097, urn:nbn:de:0183-13dgt0979

Veröffentlicht: 14. Oktober 2013

© 2013 Frick et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Objective: Malignant Mesothelioma is a neoplastic disorder occurring either in the pleura or in the peritoneum. Here we present the unique case of a 54-year-old woman with possibly simultaneous occurrence of malignant mesothelioma in the chest wall and in the umbilicus.

Methods: Retrospective case report.

Results: In January 2012, a 54-year-old obese woman presented to our institute with a rapidly growing chest wall mass located on the right side of the xiphoid. In her medical history, she had had a VATS due to a right-sided hemothorax some years ago. In addition, a slow growing umbilical mass was known for at least 7 years and had been considered as a lipoma by various dermatologists.

CT-guided biopsy of the xiphoid mass was performed, and an epitheloid malignant pleural mesothelioma could be diagnosed. Thus, a systemic chemotherapy with Cisplatin/Alimta and local radiotherapy was commenced. Since the patient showed a good response to chemo-radiotherapy and since the PET scan remained positive only in the area of the xiphoid, six months after diagnosis the xiphoid mass with a residual size of 8 x 8 cm was resected.

Nine months after the chest wall resection, and merely for aesthetic reasons, a resection of the umbilical mass was performed. Intra-operatively, the umbilical mass turned out to be a solid tumor of 8 x 4 cm in size and reaching from the skin to the peritoneum. The histology of the resected umbilical mass delivered the surprising diagnosis of an epitheloid malignant peritoneal mesothelioma.

At 18 months after diagnosis, the patient is still well but suffered recently a generalized progression with bilateral pleural and diffuse peritoneal invasion. Therefore, anew chemotherapy with Cisplatin/Pemetrexed and Vinorelbine has been started.

Conclusion: The simultaneous occurrence of a malignant pleural mesothelioma and a malignant peritoneal mesothelioma is a very rare event. Alternatively, the peritoneal mesothelioma could also have been a distant metastasis of the pleural mesothelioma or vice versa. Ultimately, the question which lesion existed first cannot be answered.