[Clinical types of thoracic cancer. Pleural mesothelioma]

Malignant pleural mesothelioma (MPM) is a rare aggressive tumour, but the worldwide incidence is increasing on account of the extensive use of asbestos in the recent past. This is the principal aetiological factor and evidence of exposure should be sought in every case under investigation. Interest in this disease has increased for several reasons: the increase in incidence in the last twenty years, the heavy exposure of several groups of workers, claims for compensation for industrial disease and other medico-legal aspects, the question of environmental exposure with no threshold and the great media interest in the subject (3 million internet pages devoted to mesothelioma). Medical interest in this disease has evolved from almost total fatalism to a real interest in active management with acceptable surgery, new cytotoxic drugs and effective combinations, biological therapies, new modalities of radiotherapy and, above all, the development of multidisciplinary strategies to set up prospective randomised comparative trials which have been largely absent in this field.