Malignant mesothelioma is a diffuse tumor that affects men more frequently than women. Sustained exposure to asbestos is the predominant risk factor. However, smoking dramatically increases risk amongst the asbestos-exposed. The latent period between asbestos exposure and onset of symptoms can be 20 to 50 years or even longer. The median age of diagnosis is 60. The tumor can spread rapidly to involve the pericardium (sac around the heart), mediastinum, and opposite pleura. Progressive pain and shortness of breath can occur. The tumor is usually associated with a pleural effusion. Differentiation of the tumor from other conditions of the pleura and other types of cancer can be difficult, even when experienced pathologists are viewing biopsy samples.
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