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Pleural mesothelioma.

N Martini, P M McCormack, M S Bains

    The Annals of Thoracic Surgery
    |January 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Pleural mesotheliomas, rare tumors, present challenges in diagnosis and treatment. Surgical resection offers curative potential for benign and localized malignant forms, while diffuse malignant types require careful surgical approach selection.

    Area of Science:

    • Thoracic Surgery
    • Oncology

    Background:

    • Pleural mesotheliomas are uncommon thoracic neoplasms.
    • Benign variants are rarely diagnosed preoperatively; resection is curative.
    • Malignant pleural mesotheliomas exhibit local aggressiveness and therapeutic difficulty.

    Purpose of the Study:

    • To differentiate between benign and malignant pleural mesotheliomas.
    • To outline treatment strategies for localized and diffuse malignant pleural mesotheliomas.
    • To present a decision-making framework for surgical intervention in diffuse malignant pleural mesothelioma.

    Main Methods:

    • Review of clinical presentation, diagnosis, and treatment of pleural mesotheliomas.
    • Comparison of surgical approaches for diffuse malignant pleural mesothelioma: extrapleural pneumonectomy versus pleurectomy with irradiation.

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  • Presentation of a stepwise selection process for optimal surgical management.

    • Main Results:

    • Localized fibrosarcomatous malignant mesotheliomas are treated similarly to other soft-part sarcomas with curative potential via wide en-bloc excision.
    • Diffuse epithelial malignant mesotheliomas have unsatisfactory treatment outcomes and rare long-term survival.
    • Plerectomy with irradiation is favored over extrapleural pneumonectomy due to wider applicability, lower morbidity, and improved survival.

    Conclusions:

    • Accurate preoperative diagnosis of benign pleural mesothelioma is infrequent, but resection is curative.
    • Wide en-bloc excision is the primary curative treatment for localized malignant pleural mesothelioma.
    • Plerectomy with irradiation offers a more advantageous approach for diffuse malignant pleural mesothelioma compared to extrapleural pneumonectomy.