Mesothelioma

When do mesothelioma typically manifest?

Aged 60-90

What is mesothelioma?

An agressive malignant epithelial neoplasm, commonly affecting the pleura.

What is the major cause of mesothelioma?

Asbestos exposure (80%)

What are the differentials for mesothelioma?

Asbestos related pleural thickening NSCLC SCLC

How is mesothelioma investigated?

CXR - pleural effusion and unilateral pleural thickening Chest CT - more sensitive Thoracocentesis - cytology of limited sensitivity VATS - more invasive but diagnostic

What is the typical presentation of mesothelioma?

Chest pain Breathlessness Cough Weight loss

How does the prognosis of mesothelioma compare to other forms of lung cancer?

Comparably poor - 5-15% 5yr survival

How is mesothelioma managed?

Drain pleural effusion ± pleurodesis Chemo ± radiotherapy

What is the character of the cough in mesothelioma?

Dry and non-productive

What is the role of the CXR in mesothelioma investigation?

It is an initial test, however it is a blunt tool that does not provide good visualisation and has limited sensitivity.

What is the risk of mesothelioma metastases?

Limited - does not commonly metastasise

Once a diagnosis is established, what further tests are advised?

PFTs if surgery under consideration MRI for staging ± PET for metastases

What causes breathlessness in mesothelioma?

Pleural effusion resulting from irritation of the pleura