[Clinical aspects and course of 38 cases of malignant pleural mesothelioma observed in the Marseilles region]

Abstract

Epithelial or mixed mesotheliomas were detected in 38 patients in the region of Marseilles over a period of 9 years. Though an occupational element was involved in 80% of cases, no history of contact with asbestos could be obtained in certain of the patients. Confirmation of diagnosis requires wide pleural biopsies, because of the high level of false negatives and false positives from cytology and pleural needle biopsy. Hyaluronic acid levels are significant only when they are markedly enhanced. Local and regional tumor spread provides an aid to prognosis, but authentic metastases, with further worsening of prognosis, were detected in more than 75% of patients while still alive. Nodules appeared along the course of punctures of drainage tubes or in thoracotomy scars in 56% of cases, and appear to be a very frequent and characteristic feature of mesothelioma. Their therapy involves preventive irradiation.