[Evolutive patterns of diffuse pleural mesothelioma (author's transl)]

The clinical beginning of diffuse pleural mesothelioma is a pleurisy. Initially pleura may be normal at X-ray examination, then either a pachypleuritis or a tumorous pleura appears. Thery serious since there is in the literature no cured case. The average survival time from diagnosis to death is 15 months. At terminal stage mesothelioma does not invade the other coelomic cavities. It may remain limited to the hemithorax where it has started, invading then the organs by contiguity. Metastasis may occur but their frequency is very variable, from 30 to 70% according the literature. On a therapeutic point of view all was tried: Surgery is rarely curative but may reduce temporarily effusion pain and dyspnea. Radiotherapy at high doses produces a partial effect in some series, but results are variable. Chemotherapy: adriamycin could be the most promising agent. At present time according to many authors no treatment seems to change the course of the disease.