Mesothelioma

Last reviewed: 23 Apr 2022
Last updated: 04 Nov 2021

Summary

Definition

History and exam

Key diagnostic factors

  • family history
  • history of asbestos exposure
  • age between 60 and 85 years
  • shortness of breath
  • diminished breath sounds
  • dullness to percussion
More key diagnostic factors

Other diagnostic factors

  • male sex
  • chest pain
  • cough
  • constitutional symptoms
  • abdominal distension and/or pain
Other diagnostic factors

Risk factors

  • asbestos exposure
  • asbestos exposure during home maintenance and renovation
  • age 60 to 85 years
  • male sex
  • radiation exposure
  • genetic predisposition
  • simian virus 40 (SV-40)
More risk factors

Diagnostic investigations

1st investigations to order

  • chest x-ray
  • CT scan of the chest and upper abdomen with intravenous contrast
More 1st investigations to order

Investigations to consider

  • thoracentesis
  • pleural biopsy
  • video-assisted thoracoscopic surgery (VATS)
  • immunohistochemistry
  • chest MRI
  • PET scan
  • cervical mediastinoscopy
  • pulmonary function tests
  • FBC
  • basic metabolic panel
More investigations to consider

Treatment algorithm

ACUTE

operable disease

inoperable or recurrent disease

Contributors

Authors

Anish Thomas, MD, MBBS

Staff Clinician

Center for Cancer Research

Thoracic and Gastrointestinal Oncology Branch

National Cancer Institute

Bethesda

MD

Disclosures

AT declares that he has no competing interests.

Jaydira del Rivero, MD

Medical Oncology Branch

Center for Cancer Research

National Cancer Institute

Bethesda

MD

Disclosures

JdR declares that he has no competing interests.

Mary Hesdorffer, MS, APRN

Nurse Practitioner

Executive Director

Mesothelioma Applied Research Foundation

Alexandria

VA

Disclosures

MH declares that she has no competing interests.

Acknowledgements

Dr Anish Thomas, Dr Jaydira del Rivero, and Mrs Mary Hesdorffer would like to gratefully acknowledge Dr Robert Taub and Dr Chris R. Kelsey, the previous contributors to this topic.

Disclosures

RT and CRK declare that they have no competing interests.

Peer reviewers

Marc de Perrot, MD, MSc

Associate Professor of Surgery

University of Toronto

Division of Thoracic Surgery

Toronto General Hospital

Ontario

Canada

Disclosures

MdP is an author of a reference cited in this topic.

Nicholas J. Vogelzang, MD

Chair and Medical Director

Developmental Therapeutics

Co-Chair

GU Committee

US Oncology Research

Comprehensive Cancer Centers of Nevada

Las Vegas

NV

Disclosures

NJV is a past chair of a US-based mesothelioma foundation. NJV is an author of a number of references cited in this topic.

Tom Treasure, MD, MS FRCS, FRCP

Professor of Cardiothoracic Surgery (Honorary)

Clinical Operational Research Unit

Department of Mathematics

University College London

London

UK

Disclosures

TT declares that he has no competing interests.

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  • Guidelines

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    • Treatment of malignant pleural mesothelioma
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