Abstract
We present the case of an 84-year-old male with a history of occupational asbestos exposure who initially developed ileus, which was later found to be related to an aggressive pulmonary malignancy. Imaging revealed extensive pleural thickening, peritoneal dissemination, and ileus. Postmortem examination confirmed a diagnosis of pulmonary spindle cell carcinoma (PSCC), supported by immunohistochemical analysis and the presence of numerous asbestos bodies in lung tissue. This case highlights the diagnostic complexity of rare thoracic malignancies, particularly when presenting with atypical features such as ileus. Further investigation is warranted to better understand asbestos-related carcinogenesis and to improve diagnostic and treatment approaches.