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2026, Vol: 51, Issue: 3
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Case Report 


Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT

Hye Ryeong Kwon, Jieun Jeong.


Abstract
We report a case of primary pleural sarcoma in a 75-year-old male with asbestos exposure, initially suspected as sarcomatoid mesothelioma. Immunohistochemical analysis confirmed the diagnosis with Vimentin positivity and negativity for mesothelial markers (Calretinin, WT-1, D2-40) and epithelial markers; focal ERG positivity was noted, but CD31 and CD34 negativity excluded angiosarcoma. The patient began chemotherapy with Adriamycin and Dacarbazine, but serial F-18 FDG PET/CT after the third cycle revealed significant metabolic progression, indicating chemotherapy refractoriness. The regimen switched to Gemcitabine and Docetaxel, but the disease remained refractory, and the patient died three months post-diagnosis. This case highlights the diagnostic complexity of primary pleural sarcoma with asbestos exposure and the critical role of serial FDG PET/CT in early metabolic progression detection. Our findings suggest early metabolic imaging integration is essential in rapidly progressing pleural malignancies to identify treatment resistance and facilitate timely clinical management adjustments.

Key words: Primary pleural sarcoma, Asbestos exposure, Sarcomatoid mesothelioma, F-18 FDG PET/CT, Chemorefractoriness, Case report


 
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How to Cite this Article
Pubmed Style

Kwon HR, Jeong J. Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. RMJ. 2026; 51(3): 890-892. doi:10.5455/rmj.20260321101314

Web Style

Kwon HR, Jeong J. Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. https://www.rmj.org.pk/?mno=314654 [Access: August 19, 2026]. doi:10.5455/rmj.20260321101314

AMA (American Medical Association) Style

Kwon HR, Jeong J. Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. RMJ. 2026; 51(3): 890-892. doi:10.5455/rmj.20260321101314


Vancouver/ICMJE Style

Kwon HR, Jeong J. Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. RMJ. (2026), [cited August 19, 2026]; 51(3): 890-892. doi:10.5455/rmj.20260321101314


Harvard Style

Kwon, H. R. & Jeong, . J. (2026) Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. RMJ, 51 (3), 890-892. doi:10.5455/rmj.20260321101314


Turabian Style

Kwon, Hye Ryeong, and Jieun Jeong. 2026. Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. Rawal Medical Journal, 51 (3), 890-892. doi:10.5455/rmj.20260321101314


Chicago Style

Kwon, Hye Ryeong, and Jieun Jeong. "Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT." Rawal Medical Journal 51 (2026), 890-892. doi:10.5455/rmj.20260321101314


MLA (The Modern Language Association) Style

Kwon, Hye Ryeong, and Jieun Jeong. "Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT." Rawal Medical Journal 51.3 (2026), 890-892. Print. doi:10.5455/rmj.20260321101314


APA (American Psychological Association) Style

Kwon, H. R. & Jeong, . J. (2026) Primary Pleural Sarcoma Mimicking Mesothelioma: Early Detection of Chemotherapy Refractoriness by Serial F-18 FDG PET/CT. Rawal Medical Journal, 51 (3), 890-892. doi:10.5455/rmj.20260321101314


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