title: Malignant pleural mesothelioma in a 17-year old boy: A case report and literature review.
abstract: BACKGROUND
  Malignant pleural mesothelioma is a rare, invasive and often fatal neoplasm that develops in the thin layer of tissue surrounding the lungs known as the pleura. Although rare, mesotheliomas do occur in the young; their characteristics are distinct from those of older patients.
  
  
  METHODS
  This is a case report of a 17-year-old boy who had moderate dyspnea, cough, right-sided pleuritic chest pain, fever, headache and no weight loss. Physical examination showed a right pleural effusion and chest roentgenograms revealed a homogenous opacity on lower right hemithorax. Biochemical analysis of pleural fluid showed hemorrhagic/turbid effusion compatible with exudate. It was initially treated as an empyema. The pleural fluid culture was negative. Adenosine deaminase level was 34.3 U/L (admission) and 19.02 U/L (two weeks after). Pleural fluid smear and culture for Mtb were negative. During the open pleural biopsy, thickened pleura and multiple pale yellow nodules in the lung were observed. The histopathological report was compatible with malignant pleural mesothelioma. With this diagnosis, a chemotherapy regimen with cisplatin was initiated. After two cycles, the patient had no clinical and radiological improvement. The patient is currently under regular follow up.
  
  
  CONCLUSIONS
  MPM is rare in young adults and its clinical presentation makes it different from mesothelioma in elderly patients, so it will be necessary to identify the new risk factors that can identify these patients.
authors.affiliation: Hospital General Tercer Milenio. Instituto de Salud del Estado de Aguascalientes, Av. Siglo XXI s/n Col. Satélite Morelos, Aguascalientes 20140, México.
authors.forename: C
authors.initials: C
authors.lastname: Pérez-Guzmán
authors.affiliation: Depto. de Bioquímica y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias-SSA, Clza. Tlalpan, 4502, Col Sec. XVI. México, D.F., 14080, México.
authors.forename: R
authors.initials: R
authors.lastname: Barrera-Rodríguez
authors.affiliation: Hospital General Tercer Milenio. Instituto de Salud del Estado de Aguascalientes, Av. Siglo XXI s/n Col. Satélite Morelos, Aguascalientes 20140, México.
authors.forename: J
authors.initials: J
authors.lastname: Portilla-Segura
keywords: Malignant pleural mesothelioma; Pneumothorax; SEER analysis; Tumors in children