Localized Fibrous Mesothelioma of the Pleura

Overview

A localized fibrous mesothelioma of the pleura is a relatively rare tumour with an incidence of 2.8/100 000 patients and it is found more frequently in women. In 80% it is asymptomatic, most frequently it is diagnoed during an incidental X-ray of the chest. The most serious symptoms include pain on the chest, cough, dyspnoea, pleurl syndom, arthralgia, hypertrofihc pulmonary osteoarthropathy and hypoglycaemia. The diagnosis is assisted by a skiagram of the chest, CT examination, MRI. Morphological diagnosis facilitated by transparietal biopsy of the tumour under CT control or biopsy during videothoracoscopy (VTS). Treatment is surgical using thoracotomy, in rare instances videoassisted thoracoscopy. The prognosis of patients after radical resection is favourable in well defined lesions, in stalked tumours and if there are no histological signs of malignant behaviour of the tumour (nuclear polymorphism, frequent mitoses). Relapses in these tumours are found in 10%, they are frequent in tumours with a malignant potential where also the presence of remote metastases is possible.

Key words:
localized fibrous mesothelioma of the pleura - transparietal biopsy - thoracotomy - videothoracoscopy.