Biological (or cellular) noise is the random quantitative variability of proteins and other molecules in individual, genetically identical cells. As the result of biological noise in the levels of some transcription factors that determine a cell's differentiation status, differentiated cells may dedifferentiate to a stem cell state given a sufficiently long time period. Here, to provide direct evidence supporting this hypothesis, we used a live-cell monitoring system based on eGFP expression to continuously assess the "stemness" of individual human and murine malignant mesothelioma (MM) cells over a period of up to 3 months. Re-expression of the transcription factors, the top hierarchical stemness markers SRY-box 2 (Sox2) and octamer-binding transcription factor (Oct4), monitored as cells' eGFP expression was observed in a subpopulation of differentiated eGFP(-) MM cells. However, we found that this transition was extremely rare. Of note, when it did occur, neighboring cells that were not direct descendants of a newly emerged eGFP(+) stem cell were more likely than non-neighboring cells to also become an eGFP(+) stem cell. This observation suggested a positional effect and led to a clustered "mosaic" reappearance of eGFP(+) stem cells. Moreover, stem cells reappeared even in cell cultures derived from one single differentiated eGFP(-) cell. On the basis of our experimental in vitro and in vivo findings, we developed a tumor growth model to predict the clustered localization of cancer stem cells within a tumor mass.Regarding the heterogeneity with respect to differentiation, cancer cell populations consist of cancer stem cells (CSC) and a majority of non-CSC or 'bulk' cancer cells. It is hypothesized that essentially the CSC subpopulation possesses the capability of tumor initiation and has the capacity for self-renewal (1,2). Two main theories were initially developed to explain the distribution of CSC within a tumor: the hierarchical and the stochastic model (1). The hierarchical model suggests that the pool of CSC can only be maintained by cells that have CSC characteristics and by definition, the ability to give rise to progeny with unlimited proliferative capacity. Thus, tumors contain: I) proliferating CSC that The cells in such a tumor do not operate in a deterministic, "well-organized" system -any cell has the same intrinsic potential to contribute to tumor growth. Unlike in the hierarchical model, the stochastic model predicts that CSC are not necessarily and exclusively derived from the CSC cell population. Currently, there is no definitive proof in favor of either model of tumor growth. The development of different cancer types may be explained in different ways; leukemia are thought to mostly follow the hierarchical model (3), while breast cancers likely develop according to the stochastic approach (4).Malignant mesotheliomas (MM) are tumors originating from the serosal cells covering the pleural, peritoneal or pericardial cavities. MM are highly aggressive neoplasms most often associated with...