![Mesotheluima is the malignant disease of the pleural , is an aggressive Disease , arising from the serosal lining of the chest . Characterized by Poor survival rate . Aetiology ;- Strongly associated with cigarette smoking . Caused by asbestose exposure ( perlonged latent peroid after exposure ) Erionite fibers Thorium dioxide . Pathology ;- Mesothelioma arise from the parietal or visceral pleural and grow diffusely Within the pleural space , commony associated with pleural effusion and Encasement of the lunge by sold mass . Tumour spread directly to the lunge , mediastinum & may cross the diaphragm To involve peritoneum . Other organs which may involve e .g liver Histological subtypes ;- ,[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Mesothelioma
- 1. MESOTHELIOMA DR/ OMAR HASHIM
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- 15. TREATMENT ; stage 1 ,2 ;- if resectable N0 ; pneumonectomy ( epp ) -> 4—6 Week break ->-> RT 1.8 /54 GY . IF resectable /N+ or medically unsuitable for EPP consider pleurectomy /decortication ->4 –6 week RT 1.8 /54 GY * IF surgically inoperable -> neoadjuvant chemo and reevaluate for resection , if remain unresectable continue chemo . MS ;;-stage 1 ;-35 months ……….. Stage 2 , 16 months . Stage 3-4 ;- primary EPP followed by stage 3 ;- 12 months adjuvant RT ± chemo Vs . Neo adj- chemo -> resection ->-> RT 1.8 /54 GY ± adj CT . Stage 3 -> 12 months ……. Stage 4 -> 6months .