Mesothelioma: History and Physical
Mesothelioma: History:
1. plueritic chest pain and dyspnea in 75% of patients is due to accumulation of pleural fluid.
- dull pain referred to upper abdomen or shoulder
- cough
- fever and sweats
2. Peritoneal involvement: abdominal pain and weight loss
- signs of abdominal obstruction
- abdominal swelling in spite of weight loss
3. Patient may be asymptomatic and disease is picked up incidentally on routine exam.
4. Presence of pleural or peritoneal fluid on X-ray
*Care should be taken when dealing with abdominal symptoms suggestive of peritoneal mesothelioma to always rule out a primary pulmonary source. Plueral mesothelioma is more common and very apt to metastasize to the peritoneal surface.
Physical Findings:
- Presence of pleural or peritoneal effusion on physical exam.
- Intermittent hypoglycemia
- Pleural Mesothelioma may have supraclavicular or axillary lymphadenopathy
- Evidence of bony metastasis
- Occasionally will see evidence of superior vena cava syndrome, Horner's syndrome or cord compression with metastasis to the nervous system.
