Long-term survival of nonoccupational pleural mesothelioma: a case report and review of the literature

Introduction: Malignant mesothelioma is an aggressive cancer that arises from the mesothelial cells lining the pleura, peritoneum, pericardium, or tunica vaginalis. While occupational exposure accounts for most cases, nonoccupational exposures (to ionizing radiation, carbon nanotubes, and different natural fibers) remain important and under-recognized. The rarity of nonoccupational pleural mesothelioma cases with prolonged survival substantiates a detailed analysis of the presented clinical case to increase awareness and review and contribute to the scientific literature. Case presentation: We present a clinical case of a 64-year-old Caucasian male patient still alive after a diagnosis in 2017 of epithelial-type pleural mesothelioma and three episodes of pleuritis accompanied by dyspnea, fever, and chest pain. The patient lived near a contaminated area but no other exposure was reported. The diagnosis was established by thoracic computed tomography scan and thoracentesis. The patient subsequently underwent chemotherapy and pneumonectomy, followed by semiannual follow-up visits that showed no evidence of disease recurrence. Conclusion: This case highlights the importance of considering nonoccupational risk factors in patients with pleural mesothelioma and suggests that long-term survival can be achieved with early diagnosis and multimodal treatment. This literature review supports the need for further studies to improve the understanding and management of nonoccupational pleural mesothelioma.