RESUMO
Pleural malignant mesothelioma is a locally invasive tumor that tends to progress due to direct extension of the tumor into the pulmonary parenchyma, the chest wall, the mediastinum, or the abdominal cavity via the diaphragm. In the later stages of the disease, distant metastases can occur. Metastases to the nervous system are rare, and clinical signs of nervous system involvement typically appear between 2 months and 6 years after the primary diagnosis. However, the case presented here manifested as neurological impairment without any respiratory symptoms.
Assuntos
Amianto/toxicidade , Carcinógenos/toxicidade , Mesotelioma/complicações , Mesotelioma/diagnóstico , Exposição Ocupacional/efeitos adversos , Neoplasias Pleurais/complicações , Neoplasias Pleurais/diagnóstico , Compressão da Medula Espinal/etiologia , Idoso , Dor nas Costas/etiologia , Diagnóstico Diferencial , Evolução Fatal , Humanos , Perna (Membro) , Imageamento por Ressonância Magnética , Masculino , Mesotelioma/induzido quimicamente , Mesotelioma/terapia , Debilidade Muscular/etiologia , Cuidados Paliativos/métodos , Paralisia/etiologia , Neoplasias Pleurais/induzido quimicamente , Neoplasias Pleurais/terapia , Compressão da Medula Espinal/complicações , Vértebras Torácicas , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To investigate asbestos exposure in 4 patients (3 cases of malignant mesothelioma and 1 case ofpleural plagues) previously employed in the entertainment business. METHODS: The patients were seen at the Occupational Health Unit of the "Clinica del Lavoro Luigi Devoto" in Milan (Italy). Information regarding exposure to asbestos (occupational, environmental, and familial) was collected through a standardized questionnaire administered to the patients by an occupational physician. RESULTS AND CONCLUSION: The presence of asbestos in the building structures and its use were described by all patients. The presence of asbestos in public buildings used for entertainment such as cinemas and theatres was in fact confirmed by the Occupational Health Services of the Local Heath Unit. An occupational aetiology was recognised in all the cases mentioned above, thus leading to the identification of an atypical occupational sector at risk in the past for asbestos exposure,