Clinical aspects of malignant mesothelioma in Australia

Abstract

Australia is currently experiencing an epidemic of malignant mesothelioma. The clinical aspects of malignant mesothelioma were investigated in 295 Australian patients as part of a national study of the disease. Most patients were male (91%), with the mean age at diagnosis being 64 years. The predominant cell type was epithelial (38%) and the majority of primary tumours arose from the pleura (94%). Mean survival was poor (17.6 months from first symptom; 11.8 months from diagnosis). Patients with a pleural primary tumour were more likely to present with dyspnoea, chest pain and cough; to have a pleural effusion diagnosed radiologically; and to have metastatic spread. Patients with a peritoneal primary tumour were more likely to present with weight loss, loss of appetite, abdominal pain and ascites; to have radiologic evidence of asbestos exposure; and to have spread along a needle track created during a diagnostic tap. A minority of patients had past thoracic conditions, or radiologic findings, specifically related to previous asbestos exposure. About one fifth of patients had no known asbestos exposure. Forty-one per cent of subjects received some form of chemotherapy, radiotherapy and/or surgery, but no formal disease staging had been documented for any patient. Proper controlled trials of secondary and tertiary treatments in malignant mesothelioma are now needed.

An Unusual Case of Ascites: Pitfalls in Diagnosis of Malignant Peritoneal Mesothelioma

“…In comparison, the annual incidence of mesothelioma in the USA is 2.2 per million. 3,18,19 The percentage of mesothelioma that is peritoneal in origin is ~ 15% 7,18–26 but it varies in different studies from 3 11,27 to 50%. 26,28 …”

“… 7,30,31 Consistent epidemiological indices include male predominance and a median age at diagnosis that lies in the 6th–7th decade. 11,13,14,18,32,33 …”

“…Malignant peritoneal mesothelioma is invariably fatal 7–9 and has a median survival of < 12 months from diagnosis. 5,10–15 The bleak prognosis is in part due to late presentation and delayed diagnosis. Potentially the outlook may be altered if early diagnosis is achieved.…”

Problematik der Diagnosefindung und Therapie bei malignen Pleuramesotheliomen

“…Die am h2iufi~ten genannten Beschwerden zum Zeitpunkt der ersten ~irztlichen Untersuchung sind Dyspnoe, Thormxschmerz und Husten [3,13,18,27,32]. Diese Symptome sind auf den Pleurareiz und die intrathorakale R.aumforderung bzw.…”

Malignant intraperitoneal mesothelioma-Başkent University experience

“…The overall prevalence is 1-2 cases per million. Mostly the tumour arises from mesothelial cells in the pleura, while primary malignant mesotheliomas in the abdominal cavity comprise between 10 to 40% (4)(5)(6)(7)(8).…”