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The European Respiratory Journal Mar 1999
Topics: Clinical Trials as Topic; Combined Modality Therapy; Humans; Lymphatic Metastasis; Mesothelioma; Neoplasm Staging; Photochemotherapy; Pleural Neoplasms; Prognosis; Thoracotomy
PubMed: 10232452
DOI: 10.1183/09031936.99.13370699 -
Clinical Radiology Jun 2020Malignant pleural mesothelioma (MPM) is a primary malignancy of the pleura and is associated with a poor outcome. The symptoms and signs of malignant mesothelioma... (Review)
Review
Malignant pleural mesothelioma (MPM) is a primary malignancy of the pleura and is associated with a poor outcome. The symptoms and signs of malignant mesothelioma present late in the natural history of the disease and are non-specific, making the diagnosis challenging and imaging key. In 2018, the British Thoracic Society (BTS) updated the guideline on diagnosis, staging, and follow-up of patients with MPM. These recommendations are discussed in this review of the current literature on imaging of MPM. It is estimated MPM will continue to cause serious morbidity and mortality in the UK late into the 21st century, and internationally, people continue to be exposed to asbestos. We aim to update the reader on current and future imaging strategies, which could aid early diagnosis of pleural malignancy and provide an update on staging and assessment of tumour response.
Topics: Diagnostic Imaging; Early Detection of Cancer; Humans; Mesothelioma, Malignant; Neoplasm Staging; Pleural Neoplasms; Practice Guidelines as Topic; Societies, Medical
PubMed: 32081346
DOI: 10.1016/j.crad.2019.12.001 -
The Annals of Thoracic Surgery Jan 2011Epithelioid hemangioendothelioma is a rare neoplasm of vascular endothelial origin. It can develop in any tissue, but it occurs primarily in the soft tissue, liver, and...
Epithelioid hemangioendothelioma is a rare neoplasm of vascular endothelial origin. It can develop in any tissue, but it occurs primarily in the soft tissue, liver, and rarely in the lung. Pulmonary epithelioid hemangioendothelioma can present in the thorax in various manifestations. In the typical pulmonary forms, epithelioid hemangioendothelioma presents as either a solitary nodule, or more often as multiple, small nodules. Pulmonary epithelioid hemangioendothelioma involving the pleural space occurs in patients with disseminated disease [1, 2]. We present a case of primary pleural epithelioid hemangioendothelioma.
Topics: Female; Hemangioendothelioma, Epithelioid; Humans; Middle Aged; Pleural Neoplasms
PubMed: 21172542
DOI: 10.1016/j.athoracsur.2010.05.070 -
Bulletin Du Cancer Oct 1999The malignant pleural mesothelioma is a rare tumor of the general population. The exposure of asbestos still remains the main factor of risk, found in 72 to 95 % of the... (Review)
Review
The malignant pleural mesothelioma is a rare tumor of the general population. The exposure of asbestos still remains the main factor of risk, found in 72 to 95 % of the patients. The diagnosis is difficult. The symptoms are poor, with most often chronic pleural effusion, with dyspnea, associated with localized chest pain. The histological diagnosis is made on thoracoscopic biopsy. Analysis of the histochemical profile (PAS-D, hyaluronidase, vimentine), the use of immunochemistry (CEA, keratines), and electron microscopy can facilitate the making of the diagnosis. There is 3 different entities of malignant mesothelioma: the epithelial type, mixed, and sarcomatous. The tagging is based on thoracic scanner, to determinate the extent of the tumor, her relation with the local structures, and the possible involvement of the mediastinal lymph nodes. There is several staging systems, the Butchart's staging classification, and most recently the IMIG (International Mesothelioma Interest Group) classification. The significant prognostic factors, in multivariate analysis are: the stage of the disease, the histologic type, and the performance status of the patient. The current therapeutic maneuvers (surgery, chemotherapy, radiotherapy) did not show significant improvement of the survival. The radical surgery, like pleuropneumonectomy, should be consider only for patients with an early stage of the disease. The chemotherapy, with single agent or in combination, still remains disappointing, with objective response rates between 20 and 30 %, in best cases. The curative radiotherapy is limited by the importance of the target-volume, and the proximity of critical organ (lung, heart). Only the preventive radiotherapy, on scars, niddle or surgical tracts is recommended. Immunotherapy, by systemic or intracavitary administration, remains limited because of the toxicity, especially infection. All of the therapeutic maneuvers should be proposed in clinical trials.
Topics: Humans; Mesothelioma; Neoplasm Staging; Pleural Neoplasms; Prognosis; Risk Factors
PubMed: 10585573
DOI: No ID Found -
Anales de Pediatria (Barcelona, Spain :... Jun 2003Solitary fibrous tumors of the pleura are uncommon mesenchymal tumors that have been reported in adults. There are very few cases in children. These tumors are...
Solitary fibrous tumors of the pleura are uncommon mesenchymal tumors that have been reported in adults. There are very few cases in children. These tumors are considered benign but their behavior is often unpredictable because they can invade nearby structures and transform into malignant variants after several years. Their clinical presentation is diverse but generally asymptomatic and they are detected incidentally in routine radiologic studies. Prognosis depends firstly on resectability of the tumour and secondly on its size, mitotic count, polymorphism, and necrosis within the tumour. Surgical resection is usually curative. Long-term follow-up is recommended because local recurrences can occur after surgery. We report the case of an asymptomatic 15-year-old girl with a giant thoracic mass revealed incidentally on a chest radiograph. Physical examination revealed thoracic asymmetry and no sounds of breathing were found in the right lung. Computerized tomography and magnetic resonance images showed the giant size of the mass. Preoperative fine needle biopsy was performed. Intraoperative biopsy confirmed the diagnosis. Although histologically benign, the tumors may enlarge rapidly. In the present case, because of the localization and size of the tumor, the patient was at increased risk. The tumour was resected and the postoperative course was uneventful. At present our patient remains under long term annual follow-up.
Topics: Adolescent; Female; Fibroma; Humans; Magnetic Resonance Imaging; Neoplasm Staging; Pleural Neoplasms; Tomography, X-Ray Computed
PubMed: 12781119
DOI: 10.1016/s1695-4033(03)78129-6 -
Expert Review of Respiratory Medicine Dec 2019: Malignant pleural mesothelioma (MPM) is a rare neoplasm with asbestos exposure as the dominant etiologic agent. Owing to the long latent period following exposure, MPM... (Review)
Review
: Malignant pleural mesothelioma (MPM) is a rare neoplasm with asbestos exposure as the dominant etiologic agent. Owing to the long latent period following exposure, MPM is often diagnosed late in life. Despite this, elderly patients are under-represented in clinical trials. To date, data regarding the tolerability and efficacy of anticancer treatments for elderly patients affected by MPM are still lacking.: The current state-of-the-art of approved treatments employed in the treatment of MPM elderly patients is reviewed and discussed, with a look to emerging therapies. A structured search of bibliographic databases for peer-reviewed research literature and of main meeting abstracts using a focused review question was undertaken.: Even though the median age of MPM patients enrolled in the most recent experimental trials is increasing, no specific analysis has been reported so far in the elderly. Moreover, no data are available for the 'oldest of the elderly' (>75 years). Treatment of elderly patients with MPM is one of the major challenges to the clinician. There is a clear need of large, well-conducted retrospective studies and above all of prospective investigations in this patient population, both in the first-and in the second-line setting.
Topics: Aged; Combined Modality Therapy; Humans; Immunotherapy; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Pleural Neoplasms; Treatment Outcome
PubMed: 31596154
DOI: 10.1080/17476348.2019.1678386 -
Chest Surgery Clinics of North America Aug 1994A wide spectrum of diseases involve the pleura. Many of these occur as complications of other disease processes, such as infectious pneumonitis, although a pleural... (Review)
Review
A wide spectrum of diseases involve the pleura. Many of these occur as complications of other disease processes, such as infectious pneumonitis, although a pleural effusion or a pleuritis also can be the primary manifestation of a disease. The most common primary neoplasm involving the pleura is a mesothelioma. It is of interest because of its causation by asbestos and because of its wide spectrum of histologic variability. Metastatic tumors also frequently involve the pleura but may not necessarily be biopsied. One type of metastatic neoplasm involving the pleura that may be extremely difficult to differentiate from an epithelial mesothelioma is a pseudomesotheliomatous carcinoma. In most instances, malignant neoplasms can be diagnosed accurately and distinguished from one another by ancillary techniques, such as immunohistochemistry and electron microscopy.
Topics: Diagnosis, Differential; Humans; Mesothelioma; Pleural Diseases; Pleural Effusion; Pleural Neoplasms
PubMed: 7953476
DOI: No ID Found -
Der Pathologe Nov 2014The World Health Organization (WHO) classification differentiates between pleural tumors of mesothelial and mesenchymal origin as well as lymphoproliferative disorders,... (Review)
Review
The World Health Organization (WHO) classification differentiates between pleural tumors of mesothelial and mesenchymal origin as well as lymphoproliferative disorders, with malignant mesotheliomas forming the most common pleural primary tumor. Histologically, epithelioid (40-60 %), sarcomatoid (20-40 %), and biphasic mesotheliomas (20-40 %) are distinguished. The certain morphological diagnosis of a malignant pleural mesothelioma requires the establishment of mesothelial differentiation by means of an appropriate panel of antibodies to exclude pleural dissemination of a pulmonary or extrapulmonary epithelial malignancy and also requires the establishment of at least focal invasive growth to distinguish from reactive mesothelial proliferation. The exclusion of a malignant pleural mesothelioma may induce further differential diagnostic considerations, e. g. concerning the assignment to a certain primary tumor after the establishment of carcinomatous pleuritis.
Topics: Diagnosis, Differential; Humans; Lung; Mesothelioma; Neoplasm Invasiveness; Pleura; Pleural Neoplasms; Prognosis
PubMed: 25304423
DOI: 10.1007/s00292-014-1921-3 -
The Oncologist Jul 2007The incidence of malignant pleural mesothelioma (MPM) is increasing worldwide, and is predicted to peak in the next 10-20 years. Difficulties in MPM diagnosis and... (Review)
Review
The incidence of malignant pleural mesothelioma (MPM) is increasing worldwide, and is predicted to peak in the next 10-20 years. Difficulties in MPM diagnosis and staging, especially of early disease, have thwarted the development of a universally accepted therapeutic approach. Single modality therapies (surgery, radiotherapy, chemotherapy) have generally failed to significantly prolong patient survival. As a result, multimodality treatment regimens have been developed. Radical surgery with extrapleural pneumonectomy and adjuvant treatments has become the preferred option in early disease, but the benefits of such an aggressive approach have been questioned because of significant treatment-related morbidity and mortality. In the past few years, there have been several major advances in the management of patients with MPM, including more accurate staging and patient selection, improvements in surgical techniques and postoperative care, novel chemotherapy regimens with definite activity such as antifolate (pemetrexed or raltitrexed)-platinum combinations, and new radiotherapy techniques such as intensity-modulated radiation therapy. Induction chemotherapy followed by surgery and adjuvant radiotherapy has shown promising results. A number of molecular alterations occurring in MPM have been reported, providing broader insights into its biology and leading to the identification of new targets for therapy. However, currently available treatments still appear to have modest results. Further studies are needed to provide evidence-based recommendations for the treatment of early and advanced stages of this disease.
Topics: Combined Modality Therapy; Humans; Mesothelioma; Neoplasm Staging; Pleural Neoplasms; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 17673616
DOI: 10.1634/theoncologist.12-7-850 -
Seminars in Thoracic and Cardiovascular... 2009
Topics: Chemotherapy, Adjuvant; Humans; Mesothelioma; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Pleural Neoplasms; Radiotherapy, Adjuvant; Thoracic Surgical Procedures; Treatment Outcome
PubMed: 19822279
DOI: 10.1053/j.semtcvs.2009.07.005