title: [Problems in diagnosis and therapy of malignant pleural mesothelioma].
abstract: The incidence of malignant pleural mesothelioma increased continuously during recent years. This is related to widespread use and processing of asbestos in the last decades. Characteristical symptoms like dyspnea, cough and thoracic pain are common in almost all pulmonal diseases. Therefore the possible occurrence of a pleural tumor is often neglected. This leads to a delay between onset of symptoms and the establishment of diagnosis. With X-ray and computed tomography 80% of the pleural tumors can be proved. Only in few cases the histopathological analysis of the pleural fluid leads to diagnosis. However, thoracoscopy or thoracotomy remain the most reliable means of obtaining a definitive tissue diagnosis. At the time of operation advanced stages are found in many cases, therefore palliative surgery is indicated. Due to high morbidity and mortality pleuropneumonectomy should be done only in selected patients. Pleurectomy or pleurodesis is often sufficient to release patients' symptoms. Chemotherapy and radiation have not proven effective in controlling malignant mesothelioma. In conclusion pleural mesothelioma remains a tumor with a very poor prognosis. Long term survival is occasional even in case of multimodal treatment.
authors.affiliation: Klinik und Poliklinik für Chirurgie der Universität zu Köln.
authors.forename: A
authors.initials: A
authors.lastname: Türler
authors.forename: S P
authors.initials: SP
authors.lastname: Mönig
authors.forename: M
authors.initials: M
authors.lastname: Raab
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010994:Pleura / Q000473:pathology; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011013:Pneumonectomy; D011379:Prognosis
vernacular_title: Problematik der Diagnosefindung und Therapie bei malignen Pleuramesotheliomen.