The New England Journal of Medicine has published details of an 81-year-old man who developed a flank bulge after surgery to remove ribs and lung tissue for mesothelioma.
The case, shared by the New England Journal of Medicine (@NEJM), centres on a patient with a smoking history of around 60 pack-years — a measure that combines the number of cigarette packs smoked per day with the number of years smoked. Twenty years before the case was presented, the man had undergone surgical removal of three left ribs and a section of lung as treatment for mesothelioma, a cancer most commonly linked to past asbestos exposure. The flank bulge (an abnormal protrusion on the side of the body), which reportedly developed within a few years of that surgery, was the subject of the journal’s reader-diagnosis challenge.
The journal invited readers to review the full case details and submit a diagnosis, a format it uses to highlight unusual or instructive presentations. The case is notable for the length of time between the original surgery and the clinical presentation of the case — a gap of two decades.
Mesothelioma affects the lining of the lungs (the pleura) and is strongly associated with asbestos exposure, which was widespread in UK construction and industry through much of the twentieth century. The NHS advises that symptoms can take between 20 and 60 years to appear after initial exposure.
Anyone with a history of asbestos exposure who develops unexplained breathlessness, chest pain, or changes to their body should speak to their GP. For non-emergency health concerns, NHS 111 is available by phone or online at any time.
Key information
- Mesothelioma symptoms can take decades to appear after asbestos exposure, according to the NHS
- Speak to your GP if you have a history of asbestos exposure and develop new or unexplained symptoms
- Call NHS 111 for non-emergency health advice, available 24 hours a day
- In a medical emergency, call 999
Source: @NEJM