Tumor extension along chest wall tract after diagnostic intervention in malignant pleural mesothelioma

To confirm the risk of chest wall tract metastases following chest wall intervention for malignant pleural mesothelioma (MPM), we reviewed our institutional experience. Between 2006 and 2010, 14 patients with MPM underwent chest wall intervention for diagnosis in Kyoto University Hospital. Seven of them underwent extrapleural pneumonectomy (EPP) after the diagnosis, while seven did not undergo EPP. All patients did not show any macroscopic abnormalities around the biopsy sites suggesting chest wall tract metastases. In the seven EPP patients, tissues including the chest wall tract, which were removed were investigated pathologically for possible metastases. In two of these seven patients, diffuse extension of MPM along the chest wall tract was pathologically confirmed. In these two patients, the period between pleural biopsy and EPP was relatively short in comparison with that in the other five patients. Despite the small number of cases, the importance of resection of the chest wall tract for the diagnostic intervention might be implied at EPP.