Summary
Definition
History and exam
Key diagnostic factors
- história familiar
- história de exposição a asbesto
- idade entre 60 e 85 anos
- dispneia
- murmúrio vesicular diminuído
- macicez à percussão
Other diagnostic factors
- sexo masculino
- dor torácica
- tosse
- sintomas constitucionais
- distensão e/ou dor abdominal
Risk factors
- exposição ao asbesto
- idade entre 60 e 85 anos
- exposição ao asbesto durante a reforma e manutenção de casas
- sexo masculino
- exposição à radiação
- predisposição genética
- vírus símio 40 (SV-40)
Diagnostic investigations
1st investigations to order
- radiografia torácica
- TC do tórax e abdome superior (com contraste)
Investigations to consider
- toracocentese
- biópsia pleural
- cirurgia toracoscópica videoassistida (CTVA)
- imuno-histoquímica
- ressonância nuclear magnética (RNM) do tórax
- PET com fluordesoxiglucose (FDG)/TC
- mediastinoscopia cervical
- testes de função pulmonar
- Hemograma completo
- perfil metabólico básico
Emerging tests
- biomarcadores diagnósticos
Treatment algorithm
doença ressecável
doença irressecável ou recorrente
Contributors
Authors
Idrees Mian, MD
Hematologist Oncologis
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: mesothelioma: pleural [internet publication].Full text
Woolhouse I, Bishop L, Darlison L, et al. British Thoracic Society guideline for the investigation and management of malignant pleural mesothelioma. Thorax. 2018 Mar;73(suppl 1):i1-30.Full text Abstract
Popat S, Baas P, Faivre-Finn C, et al. Malignant pleural mesothelioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2022 Feb;33(2):129-42.Full text Abstract
Kindler HL, Ismaila N, Armato SG 3rd, et al. Treatment of malignant pleural mesothelioma: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2018 May 1;36(13):1343-73.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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