Chest
Original ResearchDisorders of the PleuraPostmortem Findings of Malignant Pleural Mesothelioma: A Two-Center Study of 318 Patients
Section snippets
Databases
The Western Australia Mesothelioma Registry (Australia) and the Coroner's Office postmortem reports from the Avon area (England) were interrogated. The Western Australia Mesothelioma Registry contains complete data on all cases diagnosed in the state. Each case in the registry is individually scrutinized by an expert panel prior to inclusion, and this database has been used in previous epidemiology reports.12, 13 The entire registry, from establishment in 1969 to May 2009, was manually searched
Demographics
A total of 344 patients with proven mesothelioma and a complete postmortem record were identified, of which 26 had primary peritoneal mesothelioma. In the 318 patients with primary pleural mesothelioma (169 from Western Australia and 149 from Avon), most (91.5%) were men, and 55.3% had a right-sided pleural mesothelioma. The detailed demographic and disease characteristics of the Australian and Avon cohorts were similar (Table 1) except for the age of death. The mean overall age of death was
Discussion
This largest postmortem report, to our knowledge, in the English-language literature describes the tumor distribution pattern and related postmortem findings in patients with MPM. The data show that pleural mesothelioma is seldom limited to the ipsilateral hemithorax, and extrathoracic (often multiple) and lymphatic involvement of mesothelioma are common. Deposits of mesothelioma can be found in most organs. No direct anatomic cause of death was identified in the majority of patients (80%)
Acknowledgments
Author contributions: Dr Brims acts as guarantor of the paper.
Dr Finn: contributed to data collection, analysis, and manuscript preparation.
Dr Brims: contributed to data collection, analysis, and manuscript preparation.
Mr Gandhi: contributed to data collection and manuscript preparation.
Ms Olsen: contributed to providing access and oversight to the Western Australian Mesothelioma Registry and approval of the manuscript.
Dr Musk: contributed to providing access and oversight to the Western
References (29)
- et al.
A systematic review of extrapleural pneumonectomy for malignant pleural mesothelioma
J Thorac Oncol
(2010) - et al.
Outcome for patients with malignant pleural mesothelioma referred for Trimodality therapy in Western Australia
J Thorac Oncol
(2009) - et al.
Malignant mesothelioma: a review of 35 cases with diagnosis and prognosis
Pathology
(1980) - et al.
The 2004 World Health Organization classification of lung tumors
Semin Roentgenol
(2005) - et al.
Diffuse malignant pleural mesothelioma in Glasgow
Br J Dis Chest
(1981) - et al.
Pleomorphic epithelioid diffuse malignant pleural mesothelioma: a clinicopathological review and conceptual proposal to reclassify as biphasic or sarcomatoid mesothelioma
J Thorac Oncol
(2011) Pleomorphic mesothelioma: report of 10 cases
Mod Pathol
(2012)- et al.
The global burden of disease due to occupational carcinogens
Am J Ind Med
(2005) - et al.
Asbestos use and asbestos-related diseases in Asia: past, present and future
Respirology
(2011) Asbestos—a legacy and a persistent problem
J R Nav Med Serv
(2009)
Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial
Eur Respir J
Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma
J Clin Oncol
Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour
Thorax
Malignant mesothelioma in south east England: clinicopathological experience of 272 cases
Thorax
Cited by (84)
Nonmesothelial Spindle Cell Tumors of Pleura and Pericardium
2024, Surgical Pathology ClinicsPembrolizumab plus chemotherapy for pleural mesothelioma
2023, The LancetExtrathoracic Metastases in Pleural Mesothelioma
2023, JTO Clinical and Research ReportsPleural mesothelioma
2022, Medicine (Spain)Pleural mesothelioma
2022, Medicina ClinicaMetastasis of malignant pleural mesothelioma to the scalp following chemotherapy: A case report and review of the literature
2022, Revista Espanola de PatologiaCitation Excerpt :The most frequent sites of metastasis associated with these tumours are regional lymph nodes, lung, liver, adrenal glands, kidneys,1–7,9,10 as well as a few cases of subcutaneous nodules.10,13 In post-mortem studies, extrapleural dissemination of these tumours has been detected in the liver (31.9%), spleen (10.8%), thyroid gland (6.9%) and brain (3%),7,10,11,14 while cutaneous metastases from MPM are rare.1,4,5,11 Exceptionally, distant metastases have also been diagnosed10 in the lips,1,5,10 oral cavity (floor of the mouth-gingival),4 face,1,3,5 umbilicus,5,7,12 scalp,5,6,8,9 cerebellum,6 fingers,1 neck,15 tongue,5,7,13 trunk,5 flank,2,5 abdominal wall,5 bone,4 upper back,11 skeletal muscle,5 and lacrimal gland.16
Drs Finn and Brims contributed equally as joint first authors. Drs Maskell and Lee contributed equally as last authors.
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.