Mesothelioma is a cancer that is difficult to diagnose and treat. Sarcomatoid mesothelioma is the most aggressive type of mesothelioma. It also looks different from other types of mesothelioma, making it even harder to diagnose and treat.
The cause of mesothelioma is exposure to asbestos. It takes decades for symptoms of this cancer to appear, and the symptoms often look like other diseases, like pneumonia. A proper diagnosis can take a long time, which means the cancer has more time to spread.
Mesothelioma can be categorized into three groups: epithelioid, sarcomatoid, and biphasic. The type of mesothelioma a patient has depends on the shape of the cancer cells. Epithelioid mesothelioma has cube-shaped or column-shaped cells. Sarcomatoid mesothelioma has cells with an oval, spindle shape. When the mesothelioma cells are a mix of cube-shaped and spindle-shaped, it falls into the biphasic category.
When it comes to treatment, epithelioid and biphasic mesothelioma are much easier to treat than sarcomatoid mesothelioma. Sarcomatoid mesothelioma grows more quickly and more likely to spread to other parts of the body. It is also more difficult to identify as mesothelioma.
A Hard Diagnosis
A study published in the Journal of Surgical Case Reports describes a patient with sarcomatoid mesothelioma. The patient was an elderly man who went to the emergency room with a bad cough and shortness of breath.
A chest x-ray of the patient showed a mass in the patient’s lung. The doctors also discovered that a mass in his kidney was causing problems for his blood flow. Based on these findings, the doctors believed the patient was sick with renal cell carcinoma.
The doctors also performed a biopsy of the mass in the patient’s lung. This is when a sample of the diseased tissue is taken for examination under a microscope. The biopsy revealed that the lung mass had cells shaped like sarcomatoid mesothelioma.
This was confusing for the doctors because the biopsy sample did not have the usual biomarkers of mesothelioma. Biomarkers are medical signs that point to specific conditions, like blood pressure and x-rays. Besides the shape of the cells, the mass in this patient’s lung did not have the biomarkers expected of mesothelioma.
This case is a great example of why it can be so hard to diagnose mesothelioma, and especially sarcomatoid mesothelioma. Luckily, this type of mesothelioma is the least common type to appear in patients.
Clopton B, Long W, Santos M, Asarian A, Genato R, Xiao P. Sarcomatoid mesothelioma: unusual findings and literature review. J Surg Case Rep. 2022;2022(11):rjac512. Published 2022 Nov 19. doi:10.1093/jscr/rjac512. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675762/