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Malignant mesothelioma is a rare cancer believed to be associated with prior exposure to asbestos. The tumor arises in the mesothelium, the layer of squamous epithelial cells that covers the pleura (membrane covering the lungs) or peritoneum (membrane covering the abdominal cavity). Most mesotheliomas are of pleural origin. Mesotheliomas that occur on the peritoneum begin as hard white nodules on the surface, and later form masses extending into surrounding tissue and organs; metastasis is usually to the lymph nodes or chest cavity. Seven cases of peritoneal mesothelioma are described, and the literature is reviewed. The age range of the patients was 39 to 66 years. Six of the patients had abdominal pain which prompted them to seek medical attention. Only one patient had exposure to asbestos. Diagnosis was established by surgery in six patients; the seventh patient was diagnosed by autopsy after death. Five patients had biopsy or partial excision of the tumor and received chemotherapy; four died within one year. One chemotherapy patient survived for seven years. The sixth patient, who had total excision of the mesothelioma with reoccurrence and re-excision, is still alive 15 years after diagnosis. Most of the cases of mesothelioma reported in the literature were pleural in origin; between 20 and 40 percent of mesotheliomas are peritoneal in origin. The diagnosis of this condition is difficult because it is rare and its presenting symptoms are varied and nonspecific. (Consumer Summary produced by Reliance Medical Information, Inc.)

Malignant mesothelioma was once a relatively rare cancer, but is now increasing due, at least in part, to environmental exposure to asbestos. Research is uncovering other etiologic agents as well, including radiation and zeolites, a class of silicate minerals sometimes used in water softeners and other ion-exchange applications. The majority of patients with malignant mesothelioma are over 40 years of age. Of 181 patients seen with malignant mesothelioma, 11 were under the age of 40. Of these, 10 were available for study and follow-up. Seven patients had histories of asbestos exposure. The median age at initial exposure was 10 years, and the median duration of exposure was 10 years. The median latency, or the time between initial exposure and diagnosis, was 19 years. When compared to mesothelioma patients as a whole, the younger patients were slower to be diagnosed with the disease. The decreased incidence of cancer in this age group, and the rarity of mesothelioma, no doubt delay the consideration of this possibility when symptoms are seen in younger patients. Among these patients, the male to female ratio was 0.7 to 1.0, in marked contrast to other studies which have shown a preponderance of male cases. It is believed that these sex differences represent a difference in exposure to environmental asbestos rather than an increased susceptibility among men. The difficulty with diagnosis suggests that mesothelioma might be more common in patients under 40 than has been suspected, and that this diagnosis should be considered in cases of unidentified pleural or peritoneal disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Although malignant mesothelioma, which is sometimes associated with asbestos exposure, is a highly malignant cancer, there are other mesotheliomas which are either less aggressive or benign. Multicystic mesothelioma is one of these. Less is known about the well-differentiated papillary mesothelioma of the peritoneum (WDPMP). The peritoneum is the membrane that lines the abdominal cavity. Of 22 WDPMP patients seen, 18 were women, indicating that WDPMP shares the tendency of multicystic mesothelioma to occur in women. The median age of the WDPMP patients was 40 years. One of the 22 patients died of causes clearly related to the tumor, in this case, continuing ascites (accumulation of excess fluid in the peritoneal cavity) with aplastic anemia. Another two patients died of causes which make it difficult to distinguish between the effects of the tumor and the effects of the radiotherapy used for treatment. In the majority of cases, however, the tumor has an indolent nature, another feature shared with multicystic mesothelioma. Because the tumor tends to grow slowly, it is suggested that adjuvant therapy, such as radiation that is given after surgery, not be used for most patients with WDPMP. Thirteen patients are alive and well, although the disease persists in some. (Consumer Summary produced by Reliance Medical Information, Inc.)

An 81 year old electrician was admitted with exertional dyspnoea and weight loss. His exercise tolerance was decreased to 50 yards. He did not smoke, and denied chest pain or [...]

Peritoneal mesothelioma is a rare disease, but it is increasing in frequency. Because of its unusual nature, the disease has not been clearly defined either in terms of its natural history, diagnosis, or management. Peritoneal mesothelioma patients generally present with two types of symptoms and signs; those with abdominal pain, usually localized and related to a dominant tumor mass with little or no ascites and those without abdominal pain, but with ascites and abdominal distention. Prognosis as determined by clinical presentation, the completeness of cytoreduction, and gender (females survive longer than males) appears to be improved by the use of intraperitoneal chemotherapy. We would like to report a case where our patient primarily presented with peritoneal mesothelioma without pleural involvement that responded well to standard wide surgical excision and postoperative chemotherapy. Keywords: Primary | peritoneal | mesothelima, Case history A 60-year-old Hindu housewife, hailing from Chennai, came with chief complaints of a swelling over the anterior abdominal wall, slightly right of the midline for 2 months. The [...]

The article discusses the case of a 51-year-old male patient with no known history of asbestos exposure who presented with hydropneumothorax. It describes the early diagnosis of malignant pleural mesothelioma through soluble mesothelin-related protein (SMRP) testing and a combination of positron emission tomography and computed tomography, which together with radical surgery and radiotherapy, prevented clinical recurrence after one year.

Table of Contents Abstract Background Case Report Discussion Conclusions References Abstract Malignant neoplasms are unlikely to be considered in the clinical differential diagnosis of incidental umbilical nodules in patients presenting [...]

A small percentage of welders at Her Majesty's Dockyards who have been exposed to heavy amounts of asbestos dust have developed parenchymal fibrosis and mesothelioma, and approximately 13% had non-malignant pleural lesions. More research is needed to make accurate assessments of the occurrence of these diseases among dockyard welders.