Malignant Pleural Mesothelioma (MPM) Presenting as Hydropneumothorax

An 86-year-old man presented with bilateral lower limb edema and was found to have hydropneumothorax on chest radiography. CT revealed a substantial pleural effusion plaques. The patient had history of working in stone workshop, but the extent asbestos exposure remained unknown. Thoracic drainage subsequent thoracoscopic surgery confirmed presence biphasic malignant mesothelioma through pathological examination. Hydropneumothorax as presentation (MPM) is rare, only few similar cases reported. Remarkably, despite coexistence plural pneumothorax, did not experience dyspnea. examination also tumor rupture disruption pleura. Considering possibility MPM patients asymptomatic essential for early diagnosis appropriate management.