Mesothelioma
From Ganfyd
Web Resources for Mesothelioma
ICD 10 code: C45
Relevant Clinical Literature
UK Guidance
Other Wikis
Medpedia on Mesothelioma (Less technical, good quality control)
Wikipedia on Mesothelioma (Less technical, ? quality control)
Contents |
Clinical Features
Dyspnoea or chest pain, particularly around the lower ribs. It may present with pleural effusion or be noted incidentally on chest radiograph. In later stages, it may produce severe pain from infiltration of the intercostal nerves.
Epidemiology
The disease has a latency of at least 15-20 years, but more commonly presents between 30-40 years after first exposure. The incidence in the UK is expected to peak around 2015. The Peto model based on cohort exposure predicts 90,000 deaths in the UK by 2050 (250,000 on Europe), at which point, it will all but have disappeared in the West but still be a ever bigger problem in China etc. [1] The disease incidence in the US is thought to have peaked as the pattern of asbestos use was thought to include less crocidolite, the form of asbestos with the most carcinogenic properties.
One of the particular sources of asbestos exposure is the basement and sub-basement works of old hospitals, thus healthcare workers may have an excess risk.
Investigations
Radiological features combined with pleural biopsy is the usual means of diagnosis. Pleural aspiration if pleural effusion present.
There is interest in developing a non-invasive test by measuring mesothelin-related peptides.[2][3][4]. Fibulin-3 appears as of 2012 to be the most likely candidatePMID link to reference awaited
.
Histology
Broadly classified into sarcomatoid, epitheloid or a combination of both variants (biphasic).
Treatment
Limited in advanced disease. Prophylactic pleurodesis may avoid lung entrapment.
References
- ↑ Hodgson JT, McElvenny DM, Darnton AJ, Price MJ, Peto J. The expected burden of mesothelioma mortality in Great Britain from 2002 to 2050. British journal of cancer 2005;92:587-93. (Direct link – subscription may be required.)
- ↑ Robinson BW, Creaney J, Lake R, Nowak A, Musk AW, de Klerk N, et al. Mesothelin-family proteins and diagnosis of mesothelioma. Lancet. 2003;362:1612-6.
- ↑ Robinson BW, Creaney J, Lake R, Nowak A, Musk AW, de Klerk N, et al. Soluble mesothelin-related protein--a blood test for mesothelioma. Lung cancer (Amsterdam, Netherlands) 2005;49 Suppl 1:S109-11. (Direct link – subscription may be required.)
- ↑ Scherpereel A, Grigoriu B, Conti M, Gey T, Gragoire M, Copin MC, et al. Soluble mesothelin-related peptides in the diagnosis of malignant pleural mesothelioma. American journal of respiratory and critical care medicine. 2006;173:1155-60. (Direct link – subscription may be required.)
