Epithelioid Mesothelioma

Diagnosis

Epithelioid cell type makes up 70 percent of all mesothelioma diagnoses.

Epithelioid cells closely resemble cell types that make up adenocarcinoma, breast cancer, and other forms of carcinoma (cancer that affects the lining of internal organs).

Symptoms of epithelioid pleural mesothelioma may include: shortness of breath, chest pain, or pleural effusions. Epithelioid peritoneal mesothelioma symptoms can include: abdominal pain, ascites (fluid in the abdomen), or stomach distention.

In order to diagnose a patient, a physician will take a biopsy. By studying the pathology report, the doctor will check for the presence of malignant mesothelioma cells.

If cancerous cells are found in the biopsy, a physician may ask the patient about asbestos exposure. The doctor will also use a process called immunohistochemistry to confirm the patient’s diagnosis.

Immunohistochemical markers used to diagnose epithelioid mesothelioma are:

• Calretinin
• CK5/6
• Wilms’ tumor-I antigen
• D2-40

Immunohistochemistry detects proteins that are used as cancer markers in the cellular makeup of a sample that is taken. It is also the only way to definitively diagnose mesothelioma.

Treatment

Treatment for epithelioid mesothelioma is often the same for the other types of mesothelioma. Fortunately, treatment for epithelioid type mesothelioma is more effective than other types of mesothelioma.

Some patients may be eligible for an extrapleural pneumonectomy (EPP), which can significantly increase life expectancy. If tumors haven’t spread from the pleura to the actual lung patients may take advantage of a lung-sparing pleurectomy with decortication (P/D).

Those with epithelioid peritoneal mesothelioma may take advantage of cytoreductive surgery. There is no excepted staging system for peritoneal mesothelioma so finding a specialist and getting a second opinion is more important than ever.

However, other standard forms of treatment are also used, such as chemotherapy and radiation. There have also been successes with alternative treatment options, such as gene therapy, photodynamic therapy, and intensity modulated radiation therapy. These types of treatment methods are currently being researched in hopes of developing a mesothelioma cure.

Prognosis

Cell type is one of the most important factors that affect a patient’s prognosis. The prognosis for patients with epithelioid mesothelioma is often better than biphasic or sarcomatoid cell types.

Based on research, epithelioid mesothelioma grows and spreads slower than other mesothelioma cell types. However, factors like age, disease stage, and overall health can impact any patient’s life expectancy.

There are many ways patients with epithelioid mesothelioma can improve their survival, such as seeing a specialist or opting for new treatments. Learn which methods mesothelioma survivors used to extend their life in our free Mesothelioma Survivors Guide.

Subtypes

Subtypes of epithelioid mesothelioma have different sizes, shapes, and structures. They all contain epithelioid cells; however, these subtypes may react differently to certain treatment plans.

The majority of epithelioid mesothelioma subtypes are extremely rare and are often benign. These subtypes are also non-asbestos related.

• Adenoid – Adenoid epithelioid cells may be present in all of the types of mesothelioma. However, it commonly develops in the genital tract, but there have been rare cases of pleural adenocarcinoma reported. Sometimes it mimics other types of tumors, which may make it difficult to diagnose. This type of benign mesothelioma is more common in men.
• Small Cell – Small cell mesothelioma is distinct in the patterns of the shape of the cells. It accounts for less than 6 percent of mesotheliomas. It can form in the lining of the peritoneum and pleura. Sometimes it rarely develops in the pericardium. Small cell mesothelioma can sometimes be misdiagnosed as small cell lung cancer.
• Cystic – Cystic mesothelioma cells are very rare. They are non-cancerous and can develop in the peritoneal or pleural cavity. Asbestos is not the cause of multicystic mesothelioma. It can be treated with chemotherapy, radiation, and surgery just like malignant mesothelioma, but general mesothelioma statistics do not apply.
• Papillary – Papillary mesothelioma is noncancerous. It is not considered an asbestos-related illness. Papillary is more common in women than in men. This benign type can form in the lining of the abdomen or lung. It can be treated similar to malignant mesothelioma, but the normal statistics of mesothelioma do not apply.
• Deciduoid – Deciduoid mesothelioma can appear in both the peritoneum and the pleura. There aren’t very many cases that have been documented about this subtype. Of the cases that have been reported, it is more likely to appear in the abdominal cavity of females.