What Are The Presenting Signs And Symptoms Of Malignant Mesothelioma?
Malignant mesothelioma arises from mesothelial surfaces in the pleura and peritoneal cavities, the tunica vaginalis, or the pericardium. The most common presenting symptoms of pleural mesothelioma are dyspnea and chest pain. Rarely, asymptomatic patients may have a unilateral pleural effusion found incidentally on routine chest radiograph. Sixty percent of patients will have right-sided lesions, while only five percent have bilateral disease. Occasionally, the radiograph may show a pleural mass, or rind-like pleural thickening. Only 20 percent of patients diagnosed with pleural mesothelioma will show radiographic signs of asbestosis such as bibasilar interstitial fibrosis. However, most will show pleural plaques and/or calcifications.
Patients will develop shortness of breath and chest pain as the tumor invades local anatomic structures. Local invasion of thoracic structures may result in difficulty swallowing (dysphagia), hoarseness, spinal cord compression, Brachial plexus damage, and Superior vena cava syndrome. Additionally, a number of paraneoplastic syndromes can be associated with malignant mesothelioma such as DIC, thrombocytosis, Coombs-positive hemolytic anemia, hypercoagulability, hypoglycemia, and hypercalcemia of malignancy.
