Pleural Mesothelioma Secondary to Radiotherapy: A Rare Association

Malignant Pleural Mesothelioma in Patients Who Previously Received Radiotherapy for Their First Malignant Tumor

“…In this issue, Nakashima, et al reported the first Japanese case of malignant pleural mesothelioma (MPM) that developed 25 years after thoracic radiotherapy for Hodgkin's lymphoma without a history of asbestos exposure (1). A table of 29 similar cases in the literature (Table 1) ( [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] shows distinguishing features, which are summarized as follows: 1) women accounted for 55% of cases, which is much higher than the proportion of women who develop asbestosrelated MPM (<20%); 2) the median age at the diagnosis of MPM was 44 years old, whereas asbestos-related MPM is usually diagnosed in the late 50s or older (20); 3) 66% of patients had received radiotherapy for their first malignant tumor before 30 years old; and 4) the median period of latency was 16 years, which was shorter than the median period from the initial asbestos exposure to death of MPM (estimated to be ! 32 years) (21,22).…”