Malignant pleural mesothelioma treated as pulmonary tuberculosis

A 45 year old man with malignant pleural mesothelioma had symptoms of prolonged cough, heamoptysis, breathlessness, weight loss and low grade persistent fever. The high prevalence of pulmonary tuberculosis in this environment, coupled with paucity of radiologists in rural areas to competently review his chest radiograph, resulted in making the wrong diagnosis of pulmonary tuberculosis (PTB) as against malignant pleural mesothelioma. He was also wrongly treated for PTB for a period of nine months before referral to a Teaching Hospital. The correct diagnosis was made in a university teaching hospital where adequate specialized manpower was available. Distant metastasis to the liver was already observed at presentation. He was treated with six courses of chemotherapy (Peclitaxel and Cisplastin) and he did well before he was lost to follow-up. Key words: Malignant pleural mesothelioma, PTB, liver metastasis.