Metastic Mesothelioma to the Brain: A Potential Differential Diagnosic Challenge

Background: Malignant mesothelioma is a rare neoplasm arising from the mesothelial surfaces of the pleural cavity, peritoneal cavity, tunica vaginalis or pericardium that spreads mainly via direct invasion. While distant metastasis is possible, metastasis to the central nervous system (CNS) is rare. The Context and Purpose of the Study: We describe a 66-year-old male with a past medical history of mesothelioma, diagnosed approximately 1.5 years prior and treated with resection and chemotherapy, who developed an episode of right facial twitching and was found to have two left cortical frontal masses. After undergoing a frontoparietal craniotomy, the masses were diagnosed as a metastatic mesothelioma.