[Update on epidemiology, pathophysiology, diagnosis and treatment of malignant pleural mesothelioma].
Malignant pleural mesothelioma is an occupational tumor caused by asbestos exposure. In Mexico, as asbestos usage is not prohibited, an increase in the number of cases is expected. Asbestos exposure is ubiquitous due to the great amount of products in which it is present. Its carcinogenicity is caused as the inhaled asbestos fibers cannot be eliminated by macrophages and, thus, they travel to the pleura through lymphatic pathways, producing a persistent inflammatory response. Diagnosis approach includes occupational history, along with clinical signs and symptoms, and paraclinical studies, such as pleural fluid cytology, chest x-rays, computed tomography, magnetic resonance imaging, and biopsy with immunohistochemistry. The main differential diagnosis is lung adenocarcinoma. Regarding the treatment of this tumor, it mainly comprises palliative care, even though chemotherapy, radiotherapy, and, in selected cases, surgical treatments have been used. There is an urgent need for general physicians and specialists to identify asbestos exposure, in order to make a timely diagnosis. Research is necessary to develop screening and prompt diagnostic tools, along with an epidemiological surveillance program for the workers and the general population exposed to asbestos.
Servicio de Medicina Interna, Hospital Regional "Lic. Adolfo López Mateos", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México. gpeaguilarm@gmail.com.
Rodrigo
R
Gopar-Nieto
Alejandro
A
Cabello-López
Cuauhtémoc Arturo
CA
Juárez-Pérez
Luis Cuauhtémoc
LC
Haro-García
Carmina
C
Jiménez-Ramírez
Guadalupe
G
Aguilar-Madrid
D003131:Combined Modality Therapy; D006801:Humans; D008654:Mesothelioma / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D008800:Mexico / Q000453:epidemiology; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D010166:Palliative Care; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy
Asbestos; Mesothelioma; Occupational health