When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Mesothelioma

Last reviewed: 5 Oct 2024
Last updated: 01 Mar 2024

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
Full details

Other diagnostic factors

  • male sex
  • chest pain
  • cough
  • constitutional symptoms
  • abdominal distention and/or pain
Full details

Risk factors

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

Diagnostic tests

1st tests to order

  • CXR
  • CT scan of the chest and upper abdomen with intravenous contrast
Full details

Tests to consider

  • thoracentesis
  • pleural biopsy
  • video-assisted thoracoscopic surgery (VATS)
  • immunohistochemistry
  • chest MRI
  • PET scan
  • cervical mediastinoscopy
  • pulmonary function tests
  • CBC
  • basic metabolic panel
Full details

Emerging tests

  • biomarkers

Treatment algorithm

ACUTE

operable disease

inoperable or recurrent disease

Contributors

Authors

Idrees Mian, MD

​Hematologist Oncologist

Kaiser Permanente

Oncology

Washington

DC

Disclosures

IM declares he has no competing interests.

Acknowledgements

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

Disclosures

AT, JdR, MH, 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 reference 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 is an author of a reference cited in this topic.

  • Mesothelioma images
  • Differentials

    • Benign reactive mesothelial hyperplasia
    • Benign asbestos-related pleural reactions
    • Non-small cell lung cancer
    More Differentials
  • Guidelines

    • Clinical practice guidelines in oncology: mesothelioma: pleural
    • Suspected cancer: recognition and referral
    More Guidelines
  • Videos

    Pleural aspiration animated demonstration

    More videos
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer