The Curious Case of Epithelial Malignant Mesothelioma
Mesothelioma, a cancer caused by asbestos exposure, can be categorized in two ways. The first is by location such as the lungs or abdominal area and the second by type of tissue cells involved. Epithelial malignant mesothelioma is one kind of the cancers that affect the epithelial tissues that cover body cavities. Other forms of mesothelioma afflicting tissue cavities are sarcomatoid and biphasic. Sarcomatoid is the less common of the two varieties and is the most difficult version to diagnose because it's resistant to treatment and its cells look similar to those of another type of cancer called carcinoma. Biphasic mesothelioma is also known as 'mixed' mesothelioma because it is a combination of both epithelial and sarcomatoid cells to make biphasic mesothelioma tumors. Epithelial malignant mesothelioma is the most common pleural mesothelioma. Mesothelial cells are a type of epithelial cell found throughout the body. They become cancerous when malignant mesothelioma develops in the pleura, peritoneum or pericardium. Epithelial malignant mesothelioma is mostly common in the pleura and mainly causes breathlessness and chest pain. Some patients experience both symptoms while others experience the dyspnea without chest pain due to pleural effusions. Other symptoms such as dysphasia are possible but it is normally discovered late. Weight loss, sweating and chest wall masses are less common symptoms. Other non specific symptoms which indicate the possibility of the condition include nausea, loss of appetite, constipation, diarrhea, vomiting and occasionally ascites. In later stages symptoms such as small bowel obstruction may be experienced. Epithelial malignant mesothelioma mainly affects adults between 50-70 years of age and its occurrence is directly related to a history of asbestos exposure. Individuals diagnosed with this type of cancer have been exposed to asbestos as children. Cases of spontaneous mesothelioma without exposure to asbestos exist but are rare. Physical examination can only detect pleural thickening due to tumor infestation and signs of pleural effusion. The mesothelioma tumor develops mainly on the pleura and starts spreading via the pleural fissures and finally encases the lung surfaces. Epithelial malignant mesothelioma can spread along surgical incisions and needle tracks. In some cases mesothelioma has been associated with autoimmune hemolytic anemia and blood tests can be used to diagnose an elevated erythrocyte sedimentation rate. Diagnosis of asbestos is done by using a combination of the history of asbestos exposure together with radiology and pathology exams. Deciduoid mesothelioma is a sub category of epithelial malignant mesothelioma in which the cells are large and have cytoplasm that stands out when viewed under the microscope. This type of epithelial cancer is found around the abdomen region. It is common among women. Prognosis varies for individuals diagnosed with epithelial malignant mesothelioma. Deciducoid sufferers have a better prognosis than those with either sarcomatoid or biphasic mesothelioma. Treatment is by radiotherapy, chemotherapy, surgery, and symptom palliation. Victims generally follow less aggressive treatment courses with the specific treatment option dependent on the patient. Life expectancy for people suffering from epithelial malignant mesothelioma is poor with the median survival rate being one year after diagnosis.
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