Malignant mesothelioma

Abstract

Malignant mesothelioma is a fatal asbestos-associated malignancy originating from the lining cells (mesothelium) of the pleural and peritoneal cavities, as well as the pericardium and the tunica vaginalis. The exact prevalence is unknown but it is estimated that mesotheliomas represent less than 1% of all cancers. Its incidence is increasing, with an expected peak in the next 10-20 years. Pleural malignant mesothelioma is the most common form of mesothelioma. Typical presenting features are those of chest pain and dyspnoea. Breathlessness due to a pleural effusion without chest pain is reported in about 30% of patients. A chest wall mass, weight loss, sweating, abdominal pain and ascites (due to peritoneal involvement) are less common presentations. Mesothelioma is directly attributable to occupational asbestos exposure with a history of exposure in over 90% of cases. There is also evidence that mesothelioma may result from both para-occupational exposure and non-occupational "environmental" exposure. Idiopathic or spontaneous mesothelioma can also occur in the absence of any exposure to asbestos, with a spontaneous rate in humans of around one per million. A combination of accurate exposure history, along with examination radiology and pathology are essential to make the diagnosis. Distinguishing malignant from benign pleural disease can be challenging. The most helpful CT findings suggesting malignant pleural disease are 1) a circumferential pleural rind, 2) nodular pleural thickening, 3) pleural thickening of > 1 cm and 4) mediastinal pleural involvement. Involvement of a multidisciplinary team is recommended to ensure prompt and appropriate management, using a framework of radiotherapy, chemotherapy, surgery and symptom palliation with end of life care. Compensation issues must also be considered. Life expectancy in malignant mesothelioma is poor, with a median survival of about one year following diagnosis.

Sarcomatoid mesothelioma: a clinical–pathologic correlation of 326 cases

“…8,20,27,32,[34][35][36] In cases in which CK staining is negative, the gross distribution of tumor and absence of any history of an antecedent primary soft tissue sarcoma or intrapulmonary mass lesion with radiological features of a primary lung carcinoma may aid in making the diagnosis. [37][38][39] In this context, we advise extreme caution in making a diagnosis of sarcomatoid malignant mesothelioma in a patient with a mass present within the lung parenchyma, especially for apical masses, which frequently involve the pleura secondarily.…”

In vivo Toxicity Studies of Pristine Carbon Nanotubes: A Review

“…This cancer is a highly specific response to biopersistent fibres and may occur in the pleura (outer lining of the lungs and internal chest wall), peritoneum (the lining of the abdominal cavity), pericardium (a sac that surrounds the heart), or tunica vaginalis (a sac that surrounds the testis) (Moore et al, 2008).…”

Testicular Mesothelioma

“…On histological pattern, it has the structure of fibroma, rich in cellular elements, so it is called fibrous mesothelioma [26,27,68,69,96]. The structure of malignant mesothelioma in its main features is everywhere the same and different only in its details of macroscopic pattern and clinical course associated with the anatomical features of each serous cavity [13,75]. Macroscopically, the tumor is in the form of a dense infiltrate, causing a dramatic thickening (2-3 cm, and sometimes more) of the serous membranes in a limited area or extends to the entire parietal and visceral sheets of the tunica vaginalis surrounding the body in the form of the shell, sometimes has the form of the mild delimited node from 0.5 to 6 cm oval, or merging several nodes with the villous surface resembling moss, destroys the epididymis and causes the testicular atrophy.…”