Pain in mesothelioma: feasibility study of percutaneous image-guided radiofrequency ablation of chest wall lesions

Malignant pleural mesothelioma (MPM) is a rare tumor that originates in the lung pleura; it commonly results from previous asbestos exposure that occurred between 20 and 50 years prior to disease onset, and its incidence is increasing worldwide. Symptoms commonly related to MPM include chest pain. The causes of the pain are multifactorial: it may be due to tumor infiltration of the ribs of the nerve roots, intercostal nerves, chest wall, or, in some cases, from tumor invasion of the neurovascular bundle. Treatment of chest pain makes use of medical therapy, surgical and radiotherapy approaches.

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Chest Pain

PEDIATRICS ◽

10.1542/peds.77.4.618 ◽

1986 ◽

Vol 77 (4) ◽

pp. 618-618

Author(s):

STEVEN M. SELBST

Keyword(s):

Chest Pain ◽

Chest Wall ◽

Clinical Entity ◽

Distinct Clinical Entity ◽

Intercostal Nerves

In Reply.— Dr Rogers describes brief anterior chest pain, worse with inspiration, which he has labeled "benign pleuralgia." The etiology of this pain, as with most chest pain, is uncertain. Perhaps, the pain arises in the pain-sensitive pleura and then travels through the intercostal nerves in the chest wall. If such pain is not reproducible with palpation, and not related to recent exercise, I would not consider this to be of musculoskeletal origin. Although some may prefer to consider this a distinct clinical entity, I would "lump" such vague, unexplainable pain in the idiopathic category.

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Chondrosarcoma of the Rib Mimicking Malignant Pleural Mesothelioma

Case Reports in Oncology ◽

10.1159/000443327 ◽

2016 ◽

Vol 9 (1) ◽

pp. 11-14 ◽

Cited By ~ 1

Author(s):

Masashi Furukawa ◽

Hiroyuki Tao ◽

Toshiki Tanaka ◽

Hideko Onoda ◽

Tomoyuki Murakami ◽

...

Keyword(s):

Computed Tomography ◽

Chest Wall ◽

Malignant Pleural Mesothelioma ◽

Thoracoscopic Surgery ◽

Asbestos Exposure ◽

Excisional Biopsy ◽

Tumor Location ◽

Wide Resection ◽

Chest Wall Tumor ◽

Pleural Mesothelioma

A 62-year-old man with a history of long-term asbestos exposure was found to have a chest wall tumor invading the sixth rib on chest computed tomography. The computed tomography also revealed multiple plaques in the pleura. Malignant pleural mesothelioma was suspected, and thoracoscopic surgery was performed. Thoracoscopy revealed that the tumor location was extrapleural. Thus, excisional biopsy was performed. The tumor was histologically diagnosed as chondrosarcoma. Additional wide resection of the chest wall, including the fifth, sixth, and seventh ribs, was performed. Chest wall reconstruction was performed with a polypropylene mesh.

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SEOM clinical guidelines for the treatment of malignant pleural mesothelioma (2020)

Clinical & Translational Oncology ◽

10.1007/s12094-020-02532-2 ◽

2021 ◽

Vol 23 (5) ◽

pp. 980-987 ◽

Cited By ~ 2

Author(s):

E. Nadal ◽

J. Bosch-Barrera ◽

S. Cedrés ◽

J. Coves ◽

R. García-Campelo ◽

...

Keyword(s):

Survival Benefit ◽

Early Stage ◽

Asbestos Exposure ◽

Standard Of Care ◽

Tumor Board ◽

Pleural Mesothelioma ◽

Therapeutic Approaches ◽

Dismal Prognosis ◽

Line Chemotherapy ◽

Multidisciplinary Tumor Board

AbstractMesothelioma is a rare and aggressive tumour with dismal prognosis arising in the pleura and associated with asbestos exposure. Its incidence is on the rise worldwide. In selected patients with early-stage MPM, a maximal surgical cytoreduction in combination with additional antitumour treatment may be considered in selected patients assessed by a multidisciplinary tumor board. In patients with unresectable or advanced MPM, chemotherapy with platinum plus pemetrexed is the standard of care. Currently, no standard salvage therapy has been approved yet, but second-line chemotherapy with vinorelbine or gemcitabine is commonly used. Novel therapeutic approaches based on dual immunotherapy or chemotherapy plus immunotherapy demonstrated promising survival benefit and will probably be incorporated in the future.

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Identification of Redox-Sensitive Transcription Factors as Markers of Malignant Pleural Mesothelioma

Cancers ◽

10.3390/cancers13051138 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1138

Author(s):

Martina Schiavello ◽

Elena Gazzano ◽

Loredana Bergandi ◽

Francesca Silvagno ◽

Roberta Libener ◽

...

Keyword(s):

Oxidative Stress ◽

Transcription Factors ◽

Malignant Pleural Mesothelioma ◽

Antioxidant Defense ◽

Asbestos Exposure ◽

Predictive Biomarkers ◽

Antioxidant Systems ◽

Pleural Mesothelioma ◽

Related Factor ◽

Aggressive Cancer

Although asbestos has been banned in most countries around the world, malignant pleural mesothelioma (MPM) is a current problem. MPM is an aggressive tumor with a poor prognosis, so it is crucial to identify new markers in the preventive field. Asbestos exposure induces oxidative stress and its carcinogenesis has been linked to a strong oxidative damage, event counteracted by antioxidant systems at the pulmonary level. The present study has been focused on some redox-sensitive transcription factors that regulate cellular antioxidant defense and are overexpressed in many tumors, such as Nrf2 (Nuclear factor erythroid 2-related factor 2), Ref-1 (Redox effector factor 1), and FOXM1 (Forkhead box protein M1). The research was performed in human mesothelial and MPM cells. Our results have clearly demonstrated an overexpression of Nrf2, Ref-1, and FOXM1 in mesothelioma towards mesothelium, and a consequent activation of downstream genes controlled by these factors, which in turn regulates antioxidant defense. This event is mediated by oxidative free radicals produced when mesothelial cells are exposed to asbestos fibers. We observed an increased expression of Nrf2, Ref-1, and FOXM1 towards untreated cells, confirming asbestos as the mediator of oxidative stress evoked at the mesothelium level. These factors can therefore be considered predictive biomarkers of MPM and potential pharmacological targets in the treatment of this aggressive cancer.

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A palpable chest wall mass in a 4-year-old boy

Official Journal of the Association of Medical Microbiology and Infectious Disease Canada ◽

10.3138/jammi-2020-0053 ◽

2021 ◽

pp. e20200053

Author(s):

Jakob M Domm ◽

Joanne M Langley

Keyword(s):

Chest Pain ◽

Tract Infection ◽

Respiratory Tract ◽

Chest Wall ◽

Respiratory Infection ◽

Lower Respiratory Tract ◽

Atypical Presentation ◽

History Of ◽

Wall Mass ◽

Chest Wall Mass

Empyema necessitans (EN) is a rare but dangerous complication of a lower respiratory tract infection. The diagnosis can be difficult to make and therefore delayed. We describe a case of a child with an atypical presentation of EN. He was afebrile and without chest pain and presented with a palpable chest wall mass after a history of recent respiratory infection. The threshold of suspicion for EN should be low, and it must be suspected in all children with a chest wall mass and recent history of respiratory infection.

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Response to: Pleural mesothelioma, and occupational and non-occupational asbestos exposure: a case–control study with quantitative risk assessment.

Occupational and Environmental Medicine ◽

10.1136/oemed-2016-103776 ◽

2016 ◽

Vol 73 (10) ◽

pp. 712-712 ◽

Cited By ~ 4

Author(s):

Paolo Boffetta

Keyword(s):

Risk Assessment ◽

Case Control Study ◽

Asbestos Exposure ◽

Case Control ◽

Quantitative Risk Assessment ◽

Pleural Mesothelioma ◽

Control Study

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Clinical utility of image-guided chest wall mass biopsy: results in 28 patients

Cancer Imaging ◽

10.1102/1470-7330.2011.0006 ◽

2011 ◽

Vol 11 (1) ◽

pp. 42-47

Author(s):

Frederico Ferreira Souza ◽

Mauricio De Angelo Andrade ◽

Andrew Smith ◽

Daniel B. Dei Santi

Keyword(s):

Chest Wall ◽

Clinical Utility ◽

Image Guided ◽

Wall Mass ◽

Chest Wall Mass

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Increased Standardised Incidence Ratio of Malignant Pleural Mesothelioma in Taiwanese Asbestos Workers: A 29-Year Retrospective Cohort Study

BioMed Research International ◽

10.1155/2015/678598 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Cheng-Kuan Lin ◽

Yu-Ying Chang ◽

Jung-Der Wang ◽

Lukas Jyuhn-Hsiarn Lee

Keyword(s):

Cohort Study ◽

General Population ◽

Incidence Rate ◽

Malignant Pleural Mesothelioma ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Asbestos Exposure ◽

Pleural Mesothelioma ◽

Calendar Period ◽

Incident Cases

Objective. This paper aimed to determine the standardised incidence ratio (SIR) of malignant pleural mesothelioma (MPM) in workers exposed to asbestos in Taiwan.Methods. All workers employed in asbestos-related factories and registered by the Bureau of Labour Insurance between 1 March, 1950, and 31 December, 1989, were included in the study and were followed from 1 January, 1980, through 31 December, 2009. Incident cases of all cancers, including MPM (ICD-9 code: 163), were obtained from the Taiwan Cancer Registry. SIRs were calculated based on comparison with the incidence rate of the general population of Taiwan and adjusted for age, calendar period, sex, and duration of employment.Results. The highest SIR of MPM was found for male workers first employed before 1979, with a time since first employment more than 30 years (SIR 4.52, 95% CI: 2.25–8.09). After consideration of duration of employment, the SIR for male MPM was 5.78 (95% CI: 1.19–16.89) for the workers employed for more than 20 years in asbestos-related factories.Conclusions. This study corroborates the association between occupational asbestos exposure and MPM. The highest risk of MPM was found among male asbestos workers employed before 1979 and working for more than 20 years in asbestos-related factories.

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A CLINICAL STUDY OF MALIGNANT MESOTHELIOMA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i5.1902 ◽

2021 ◽

Vol 5 (5) ◽

Author(s):

Ankit Agarwal ◽

Abhishek Padhiar ◽

Arun Pandey ◽

Giriraj Prajapati

Keyword(s):

Weight Loss ◽

Chest Pain ◽

Malignant Mesothelioma ◽

Asbestos Exposure ◽

Symptom Duration ◽

Karnofsky Performance Score ◽

Survival Times ◽

Aggressive Tumor ◽

Histopathological Type ◽

Diagnosis Date

Background: Malignant Mesothelioma (MM) is a rare but rapidly fatal and aggressive tumor of the pleura and peritoneum with limited knowledge of its natural history. Methods: 100 patients with histopathological MM diagnosis were included. The data obtained from patient files were recorded on standard forms, prepared in advance. Age, gender, hometown, residence, asbestos usage history, latent period between asbestos exposure and diagnosis, symptoms, symptom duration, diagnosis date, diagnostic method, localization, histopathological type, routine laboratory results, stage, karnofsky performance score (KPS), treatment regimen, pleurodesis, treatment response, date of death and survival times of patients were all recorded on the forms. Results: The mean age of patients 52.31±12.36 Yrs. 62 patients were male and 38 female. Environmental asbestos exposure was determined in 75.00% of patients At diagnosis, 76.00% patients had dyspnea; 71.00% weight loss; and 64.00% chest pain. A total of 48.00% patients were smokers. Mean survival time was found to be 9.3 months in our study. Conclusion: MM related to asbestos exposure is seen frequently in Southern Rajastan. Patients present with the typical clinical features of dyspnea, weight loss, and chest pain. Keywords: MM, Absestos, Dyspnea.

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