EDISCIENCES

ABSTRACT

Abstract Malignant mesothelioma (MMe) is a highly aggressive malignancy that arises from mesothelial-lined surfaces, such as the pleura or the peritoneum, and is related to the ambiental or working exposure to asbestos. Although the industrial use of asbestos has been ban- ned in western industrialized Countries such as Italy, the incidence of MMe is expected to continue to increase for the next few decades because of the huge past usage of asbestos. The disease is cha- racterized by a prognosis of 12 months and the treatment is challen- ging due to the lack of effective chemotherapeutic agents and the diagnosis at an advanced stage. Combination chemotherapy with a platinum derivative (either cisplatin or carboplatin) and pemetrexed is considered the present standard of treatment for the rst line setting, though resulting poor median overall survival. A combina- tion of carboplatin and gemcitabine is considered as a reasonable alternative to standard pemetrexed-based combinations. CT scan is a useful tool for the disease staging; other imaging techniques are improving like the PET/CT that has the ability to detect distant and occult metastases. Novel integrated PET/MRI systems have a superior soft tissue resolution combined with the metabolic infor- mation given by the FDG PET. The diagnosis of Malignant Pleural Mesothelioma is dif cult, thoracoscopy and CT guided-FNAB may be helpful in this phase. The widespread availability and use of im- munohistochemistry have greatly improved the accuracy of diagno- sis. Molecular studies have also improved diagnostic accuracy in certain situations. The main therapeutic strategies for MMe involve multimodality treatment approaches: chemotherapy, radiation the- rapy and surgical resection. We report the case of a patient born in 1944 that had no certain ambiental or working exposure to asbestos in his life and underwent 4 lines of chemotherapy. KEYWORDS Malignant mesothelioma, epitheliod pleural mesothelioma, old patient, Overall Survival, Long-term survivor.