Mesothelioma

Incidence in USA: Approximately 2000–3000 new cases annually and decreasing. Increasing incidence in developing countries due to poor regulation of asbestos in mining and industrial use

Attributable mortality: 14 deaths per million in USA

Male to female ratio: 3–6:1

0.16% of all malignancies

Usually discovered in geriatric male undergoing lung biopsy

Pleural effusion

General debilitation from malignancy

Previous needle biopsy of lung and thoracentesis make pneumothorax a concern.

Diffuse malignant mesothelioma arises from the mesothelial surface of the pleura, peritoneum, and pericardium and the tunica vaginalis of the testis.

80–90% percent originate from the pleura.

Peak incidence 20–40 y after asbestos exposure.

Usual onset of symptoms at age 55–70 y.

Median survival after onset of symptoms is approximately 18 mo.

Diffuse mesothelioma related to asbestos exposure in 12–93% of cases

Also associated with radiation therapy, erionite exposure, chronic inflammation and fibrosis, and other agents