Extrapulmonary small cell carcinoma mimicking malignant pleural mesothelioma

Pleural small cell carcinoma with massive pleural effusion: A case report

RATIONALE

Small cell carcinoma (SCC) occurs mostly in the lung, and small cell lung cancer accounts for 13% of newly diagnosed lung cancers. Only 2.5% of SCC occurs in extrapulmonary sites, and SCC of pleural origin is especially very uncommon.

PATIENT CONCERNS

An 85-year-old man presenting with progressive dyspnea for more than 7 days.

DIAGNOSES

Computed tomography scan of the chest showed massive pleural effusion and diffuse nodular thickening of the pleura on the right chest. Sonography-guided needle biopsy of the pleural mass was performed and histologic and immunohistochemical findings revealed SCC. Since no parenchymal lung lesion was observed, the patient was finally diagnosed with SCC of the pleura (SCCP).

INTERVENTIONS

Due to the patient's old age and poor performance status, chemotherapy was not performed and only drainage of pleural effusion was conducted for symptom relief.

OUTCOMES

Dyspnea improved after pleural effusion drainage. The patient was discharged and transferred to a local medical center for hospice care.

LESSONS

Although primary SCCP is extremely rare, SCCP should also be considered as well as mesothelioma in case of presence of a pleural-based mass with massive pleural effusion.