Journal Top Ten, COLUMNS-Asbestos, June 2004

1 TITLE: 'Malignant Mesothelioma a Diagnostic Challenge'

SUMMARY: The authors present a case of an 82-year-old man, an ex-sailor, with prostatic neoplasm in hormonal 'escape' phase, that was admitted with cough and dyspnea. The chest radiograph showed extensive right pleural effusion. The diagnostic hypothesis was metastatic, infeccious and primitive neoplasm origin. A pleural biopsy revealed epithelial malignant mesothelioma confirmed by thoracoscopy, associated with prolonged occupational exposure to asbestos fibers. Although he improved with some chemotherapy, the prognosis was poor because of two malignant neoplasms. The authors discuss new differential diagnostic techniques with metastatic adenocarcinoma and target therapies …