title: Cerebral Metastasis of a Malignant Pleural Mesothelioma: A Case Report and Review of the Literature.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) is an aggressive malignant neoplasm that was thought to be a localised disease with limited metastatic capability. However, recent post-mortem studies have identified metastases to the central nervous system (CNS) in about 3% of cases.
  
  
  METHODS
  We present the case of a 65-year-old with a solitary supratentorial metastatic deposit of MPM treated with surgical resection and adjuvant whole brain radiotherapy. Despite a good surgical outcome with symptomatic recovery, the patient died of cardiopulmonary compromise five months postoperatively.
  
  
  CONCLUSIONS
  Although rare, CNS metastasis of MPM is a condition that neurosurgeons should be aware of. CNS metastases may occur via three distinct mechanisms, namely perineural spread, leptomeningeal carcinomatosis and, most commonly, haematogenous spread leading to parenchymal deposits. Surgical resection of these deposits can lead to symptomatic improvement, and together with radiotherapy, to local disease control. However, the overall survival remains poor.
authors.affiliation: Neurosurgery, Imperial College London & Imperial College NHS Trust.
authors.forename: Aswin
authors.initials: A
authors.lastname: Chari
authors.affiliation: Clinical Neurosciences, Addenbrooke's Hospital & University of Cambridge.
authors.forename: Angelos G
authors.initials: AG
authors.lastname: Kolias
authors.affiliation: Pathology, University of Cambridge.
authors.forename: Kieren
authors.initials: K
authors.lastname: Allinson
authors.affiliation: Neurosurgery, Cambridge University Hospitals.
authors.forename: Thomas
authors.initials: T
authors.lastname: Santarius
keywords: brain metastasis; mesothelioma; metastasis; neuro-oncology; neurosurgery; radiation oncology; spine metastasis