title: Malignant mesothelioma.
abstract: Malignant Mesothelioma (MM) is a rare but rapidly fatal and aggressive tumor of the pleura and peritoneum with limited knowledge of its natural history. The incidence has increased in the past two decades but still it is a rare tumor. Etiology of all forms of mesothelioma is strongly associated with industrial pollutants, of which asbestos is the principal carcinogen. Mesothelioma is an insidious neoplasm arising from mesothelial surfaces i.e., pleura (65%-70%), peritoneum (30%), tunica vaginalis testis, and pericardium (1%-2%). The diagnosis of peritoneal and Pleural mesothelioma is often delayed, due to a long latent period between onset and symptoms and the common and nonspecific clinical presentation. The definite diagnosis can only be established by diagnostic laparoscopy or open surgery along with biopsy to obtain histological examination and immunocytochemical analysis. Different treatment options are available but Surgery can achieve a complete or incomplete resection and Radical resection is the preferred treatment. Chemotherapy has an important role in palliative treatment. Photodynamic therapy is also an option under trial. Patients who successfully underwent surgical resection had a considerably longer median survival as well as a significantly higher 5-year survival. Source of Data/Study Selection: The data were collected from case reports, cross-sectional studies, Open-label studies and phase -II trials between 1973-2012.
  
  
  METHODS
  Web sites and other online resources of American college of surgeons, Medline, NCBI and Medscape resource centers were used to extract data.
  
  
  CONCLUSIONS
  Malignant Mesothelioma (MM) is a rare but rapidly fatal and aggressive tumor with limited knowledge of its natural history. The diagnosis of peritoneal and Pleural mesothelioma is often delayed, so level of index of suspicion must be kept high.
authors.affiliation: Prof. Dr. Ishtiaq Ahmed, Professor, Department of Surgery, Al-Nafees Medical College, Islamabad, Pakistan.
authors.forename: Ishtiaq
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Dr. Salman Ahmed Tipu, Assistant Professor of Surgery, Al-Nafees Medical College, Islamabad, Pakistan.
authors.forename: Salman
authors.initials: S
authors.lastname: Ahmed Tipu
authors.affiliation: Sundas Ishtiaq, Women Medical College, Abbotabad, Pakistan.
authors.forename: Sundas
authors.initials: S
authors.lastname: Ishtiaq
keywords: Asbestos; Malignant Mesothelioma; Peritoneum; Surgery