Mesothelioma

Malignant pleural mesothelioma accounts for most malignant mesotheliomas; it is a rare malignancy with an annual incidence of 3200 in the US.

Largely caused by exposure to asbestos, with a 20- to 40-year latency period between exposure and the development of malignancy; the typical patient is in the sixth to ninth decade of life.

Most patients present with shortness of breath and chest pain, which on investigation is often found to be associated with unilateral pleural effusion and pleural thickening.

Despite advances in treatment, malignant pleural mesothelioma remains a highly lethal malignancy with few long-term survivors.

Operable malignant disease should receive trimodal therapy with chemotherapy, surgery, and hemithoracic radiotherapy.

Inoperable malignant disease should receive combination chemotherapy or immune checkpoint inhibitor therapy.

Malignant mesothelioma is an aggressive epithelial neoplasm arising from the lining of the lung, abdomen, pericardium, or tunica vaginalis.[1]Carbone M, Ly BH, Dodson RF, et al. Malignant mesothelioma: facts, myths, and hypotheses. J Cell Physiol. 2012 Jan;227(1):44-58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143206 http://www.ncbi.nlm.nih.gov/pubmed/21412769?tool=bestpractice.com It is one of the few cancers related directly to an environmental exposure; asbestos is the chief causative agent.