doi: 10.5146/tjpath.2013.01156 Olgu Sunumu/Case Report 83 (Turk Patoloji Derg 2013, 29:83-86) Received : 31.01.2011 Accepted : 03.02.2011 Correspondence: İrem Hicran ÖZBUDAK Department of Pathology, Akdeniz University, Faculty of Medicine, ANTALYA, TURKEY E-mail: iremhicrang@hotmail.com Phone: +90 505 258 98 48 ABSTRACT Te prevalence of multiple primary malignant neoplasms in a single patient is reported in a wide variation. Te co-existence of malignant mesothelioma and pulmonary carcinoma is a rare entity. Herein, we reported a 60-year-old man who was a retired employee and heavy smoker. He had a suspicious history of asbestos exposure. He complained of chest pain and computerized tomography revealed a mass in the lower lobe of lef lung. Te patient underwent a lef lower lobectomy and was diagnosed as pulmonary adenocarcinoma. During follow-up two years afer surgery, the patient complained of dyspnea and chest computerized tomography scan revealed right pleural efusion and difuse pleural thickening. For the diferential diagnosis, the patient underwent wedge biopsy from the right lower lobe and was diagnosed as epithelial difuse malignant mesothelioma. Te development of malignant pleural mesothelioma and lung carcinoma could be associated with asbestos exposure. However, a history of asbestos exposure is not required for the diagnosis. Te infuence of efective anticancer therapies that improve the survival rates and increase the population ages could be related to the occurrence of a second malignancy. Key Words: Metachronous neoplasms, Mesothelioma, Lung adenocarcinoma ÖZ Bir hastada izlenen çoklu primer malign neoplazilerin prevalansı değişen oranlarda bildirilmiştir. Malign mezotelyoma ve pulmoner karsinomun birlikteliği ise nadir görülen bir antitedir. Olgumuz 60 yaşında emekli memur olan bir erkek hastadır. Ağır sigara içiciliği ve şüpheli asbest maruziyeti öyküsü vardır. Göğüs ağrısı ile başvurmuş ve bilgisayarlı tomografsinde sol akciğer alt lobda kitle tespit edilmiştir. Hastaya sol alt lobektomi uygulanmış ve pulmoner adenokarsinom olarak tanı almıştır. Bu cerrahiden 2 yıl sonra, takibinde hastanın nefes darlığı şikayeti üzerine, bilgisayarlı tomografsinde sağda plevral efüzyon ve difüz plevral kalınlaşma bulunmuştur. Hastaya ayırıcı tanı için sağ akciğer alt lob kama biyopsi uygulanmış ve epitelyal difüz malign mezotelyoma tanısı verilmiştir. Malign plevral mezotelyoma ve akciğer karsinomu gelişimi asbest maruziyeti ile ilişkili olabilir. Ancak tanı için asbest maruziyet öyküsünün olması gerekli değildir. Etkili antikanser tedavileri ile yaşam oranlarının yükselmesi ve popülasyon yaşının artması kişide ikinci malignitenin ortaya çıkması ile ilişkili olabilir. Anahtar Sözcükler: Farklı zamanlarda oluşan tümörler, Mezotelyoma, Akciğer adenokarsinomu Metachronous Malignant Mesothelioma and Pulmonary Adenocarcinoma Metakron Malign Mezotelyoma ve Pulmoner Adenokarsinom İrem Hicran ÖZBUDAK 1 , Ömer ÖZBUDAK 2 , Gökhan ARSLAN 3 , Abdullah ERDOĞAN 4 , Gülay ÖZBİLİM 1 Departments of 1 Pathology, 2 Pulmonary Medicine , 3 Radiology and 4 Chest Surgery, Akdeniz University, Faculty of Medicine, ANTALYA, TURKEY INTRODUCTION Te frst report of multiple primary malignant neoplasms in an individual patient was published at the end of the 19 th century. Since then, several papers worldwide have addressed this issue and the prevalence of multiple primary malignant neoplasms reported varies from 0.734% to 11.7% (1, 2). However, reports from Turkey indicated the prevalence to be between 0.828% and 1.03% (3, 4). Te etiopathogenesis of multiple neoplasms includes hereditary aspects, the infuence of environmental agents, previous therapies and tumor-producing hormones (5-8). Multiple neoplasms could be defned by when they occur as synchronous and metachronous. Te latter is applied for the neoplasms appearing in a single patient with an interval more than 6 months (9). Te co-existence of malignant mesothelioma and pulmonary carcinoma is a rare entity and generally such reports regard single cases and series with a small number of cases in the English literature (10-15). Moreover, this co-existence has been reported in patients with signifcant exposure to asbestos. Herein, we report a rare case of metachronous malignant mesothelioma and pulmonary carcinoma with a suspicious history of asbestos exposure.