Near Missed Case of Occupational Pleural Malignant Mesothelioma, a Case Report and Latest Therapeutic Options

Abstract

Asbestos use started to be gradually banned in Europe from 1991 onwards, and there are currently strict occupational exposure limits for asbestos. However, malignant mesothelioma has a long latency time (in some cases up to 50–60 years), so the risks related to asbestos exposure should not be forgotten. Considering the increased risk of lung cancer following the inhalation of asbestos fibers, lifetime health monitoring should be considered in people occupationally exposed to asbestos, with an emphasis on the respiratory system. An assessment of their occupational history should be performed rigorously, especially in the areas with a history of asbestos production/use, as this is a key element for an early diagnosis and appropriate treatment. This case report presents a near-missed case of occupational pleural malignant mesothelioma. The latency time between the first asbestos exposure and the diagnosis of occupational pleural malignant mesothelioma was 49 years. The accurate diagnosis was made two years after the first symptoms appeared.

A Gelatinous Pleural Effusion as a Diagnostic Clue

“…However, the pleural effusion may be recurring, hemorrhagic, and filled with a significant amount of fluid [ 14 , 15 ]. Cytological investigations for malignant pleural mesothelioma may reveal the presence of atypical cells [ 16 ]. Malignant pleural effusion currently has no known treatment; several therapeutic approaches have been tried with variable success rates [ 17 ].…”

“…However, the pleural effusion may be recurring, hemorrhagic, and filled with a significant amount of fluid [14,15]. Cytological investigations for malignant pleural mesothelioma may reveal the presence of atypical cells [16].…”

Epidemiological, therapeutic, and survival trends in malignant pleural mesothelioma: A review of the National Cancer Database

“…Indeed, we have much more effective screening and diagnostic mechanisms for most cancers and as such we are likely picking up more mesothelioma as well as more cancers in general, maintaining a steady ratio. On the other hand, this is a very indolent disease and median latency of 40 years and can be up to 50 years 11,12 . It was not until 1989 where the Environmental Protection Agency prohibited the use of asbestos in the United States with the bulk of its production during the 1970s 13 .…”

“…On the other hand, this is a very indolent disease and median latency of 40 years and can be up to 50 years. 11 , 12 It was not until 1989 where the Environmental Protection Agency prohibited the use of asbestos in the United States with the bulk of its production during the 1970s. 13 As such, the current numbers we are seeing are likely reflective of exposure 40–50 years ago before legislation was in place to control the use of asbestos, a very well‐known and documented risk factor.…”

Immunopathogenesis of Silicotuberculosis: A Literature Review

“…Due to the prolonged latency period in several occupational pulmonary diseases, such as silicosis, mesothelioma, and asbestosis, the diagnosis may be delayed, which can have detrimental effects on the course of the disease. 5 The majority of the earth's crust, 59%, is composed of the mineral silica. In order to be inhaled and reach the alveoli, silica crystal particles typically have a diameter of less than 5 µm.…”