Research progress on the role of lncRNA in the occurrence and development of malignant mesothelioma / 中华劳动卫生职业病杂志

Malignant mesothelioma (MM) is a long latency, poor prognosis and asbestos exposure related malignant disease. Long non-coding RNA (lncRNA) is a kind of RNA with a length of more than 200 nucleotides that does not encode protein. It plays an important role in epigenetic regulation, cell cycle regulation and cell differentiation regulation. Recent studies have shown that the abnormal expression or function of lncRNA is closely related to the diagnosis and prognosis of MM. In this paper, the lncRNA research on MM is reviewed to better understand the role of lncRNA in MM.

Advances in Immunotherapy for Malignant Pleural Mesothelioma / 中国肺癌杂志

Patients with malignant pleural mesothelioma (MPM) usually present with poor prognosis and short survival period, and there has been a lack of effective treatment options for a long time. Chemotherapy has limited improvement in the clinical outcome of advanced patients (the median survival is less than one year), and it is difficult to find suitable targets for targeted therapy. Recent in-depth research on immunotherapy has changed the treatment pattern of MPM. Especially, the dual immunotherapy regimen significantly improved the survival outcome of patients across subgroups and prolonged the survival time of MPM patients. Therefore, it has been approved for unresectable MPM as first-line treatment for patients. The exploration of other mono or combo immunotherapy regimens in the first and second-line settings of MPM is also underway. How to identify the best beneficial population of each regimen through predictive biomarkers is also a hot spot for researchers. This article will focus on the most up-to-date progress of MPM epidemiology, histological characteristics, pathogenesis, treatment patterns and the advances of immunotherapy in the disease.
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Analysis of the Efficacy of Pemetrexed Maintenance Therapy in Patients with Malignant Pleural Mesothelioma / 中国肺癌杂志

BACKGROUND@#Malignant pleural mesothelioma (MPM) is a highly aggressive disease arising from pleural mesothelial cells. Advanced pleural mesothelioma has a poor prognosis, with a median survival of no more than 15 months. First line standard chemotherapy regimen recommended is Pemetrexed based chemotherapy regimen, with or without bevacizumab. There is no consensus on whether patients who have received first-line standard chemotherapy can benefit from pemetrexed maintenance chemotherapy. The study aimed to investigate the efficacy and safety of pemetrexed maintenance therapy (PMT) after treatment with a pemetrexed and platinum regimen for patients with MPM.@*METHODS@#A total of 40 MPM patients were collected from Cancer Hospital Chinese Academy of Medical Sciences from January 2013 to January 2018, eligible patients were unresectable MPM, without disease progression following 4 to 6 cycles of pemetrexed and platinum, including pemetrexed maintenance therapy group (22 cases) and observation group (18 cases). The last follow-up was conducted in January 2020. The primary endpoint were progression free survival (PFS), and the secondary end points were overall survival (OS), the efficacy, adverse reactions of PMT.@*RESULTS@#The median PFS in the PMT arm was longer than that in the observation arm (8.5 mon vs 3 mon, P=0.008), but there was no significant difference in median OS (26.4 mon vs 15.7 mon, P=0.177). Objective response rate (ORR) of two group were 22.7% and 0%, respectively. The grade 3-4 toxicity in PMT group included grade 4 neutropenia in 1 patient (4.5%), grade 3 neutropenia in 1 patient (4.5%), grade 4 anemia in 1 patient (4.5%) and grade 3 nausea and anorexia in 1 patient (4.5%).@*CONCLUSIONS@#Pemetrexed maintenance therapy following initial pemetrexed and platinum chemotherapy improve PFS in patients with MPM, and is well tolerated.

Mesotelioma y ocupación: revisión de casos en Uruguay: 2002-2014 / Mesothelioma and occupation: review of cases in Uruguay: 2002-2014 / Mesotelioma e ocupação: revisão de casos no Uruguai: 2002-2014

El mesotelioma es considerado en el mundo industrializado a consecuencia de la exposición ocupacional a fibras de asbesto. A nivel país se considera una enfermedad profesional. El objetivo del presente trabajo fue conocer y describir casos de mesotelioma notificados en Uruguay entre los años 2002 y 2014, con énfasis en los aspectos de la exposición ocupacional. El presente trabajo corresponde a un estudio descriptivo retrospectivo, a partir de los casos notificados se recrearon historias médicas enlazando con datos de servicios asistenciales. Se identificaron fuentes de exposición al asbesto en diferentes ocupaciones e industrias en el país. Resultados: fueron notificados 122 casos. Se accedió a la historia clínica en un tercio (47/122). El dato ocupación estaba consignado solo en 27/47, en 3/47 se explicitaba la exposición al asbesto/amianto. Los sectores productivos identificados mayoritariamente correspondieron a transporte, metalúrgico, construcción y limpieza. Se evidenció un registro insuficiente del dato ocupación y de los antecedentes laborales. Ésta información laboral es fundamental para establecer el nexo causal de la exposición en estudio y la condición de enfermedad profesional. La gravedad de la enfermedad y el conocimiento del riesgo derivado de la exposición, laboral, justifica el desarrollo de políticas en salud ocupacional. Es necesario fortalecer la formación de los profesionales de la salud sobre la importancia del trabajo como determinante del proceso salud - enfermedad.

Mesothelioma is considered in the industrialized world as a consequence of occupational exposure to asbestos fibers - asbestos. At the country level it is considered an occupational disease. The objective was to know and describe cases of mesothelioma notified in Uruguay between the years 2002 and 2014, with emphasis on aspects of occupational exposure. The present work corresponds to a retrospective descriptive study, from the reported cases medical records were recreated linking with data from healthcare services. Sources of asbestos exposure were identified in different occupations and industries in the country. Results: 122 cases were notified. The medical history was accessed in one third (47/122). The occupation data was only in 27/47, in 3/47 the exposure to asbestos / asbestos was specified. The productive sectors identified mainly corresponded to transportation, metallurgy, construction and cleaning. Insufficient registration of occupation and employment history was evidenced. This work information is essential to establish the causal link between the exposure under study and the occupational disease condition. The severity of the disease and knowledge of the risk derived from exposure occupational, justify the development of occupation health policies. It is necessary to strengthen the training of health professionals on the importance of work as a determinant of the health - disease process.

O mesotelioma é considerado no mundo industrializado como consequência da exposição ocupacional às fibras de amianto - o asbesto. Em nível nacional, é considerada uma doença ocupacional. O objetivo foi conhecer e descrever os casos de mesotelioma notificados no Uruguai entre os anos de 2002 a 2014, com ênfase nos aspectos de exposição ocupacional. O presente trabalho corresponde a um estudo descritivo retrospectivo, a partir dos casos relatados, prontuários médicos foram recriados vinculando-os a dados de serviços de saúde. Fontes de exposição ao amianto foram identificadas em diferentes ocupações e indústrias no país. Resultados: foram notificados 122 casos. O histórico médico foi acessado em um terço (47/122). Os dados de ocupação foram apenas em 27/47, em 3/47 foi especificada a exposição ao amianto / amianto. Os setores produtivos identificados corresponderam principalmente a transportes, metalurgia, construção e limpeza. Foi evidenciado registro insuficiente de ocupação e histórico de empregos. Essas informações de trabalho são essenciais para estabelecer o nexo causal entre a exposição em estudo e a condição de doença ocupacional. A gravidade da doença e o conhecimento do risco decorrente da exposição ocupacional, justificam o desenvolvimento de políticas de saúde ocupacional. É preciso fortalecer a formação dos profissionais de saúde sobre a importância do trabalho como determinante do processo saúde - doença.

Four years stability of type D personality in patients with moderate to severe psoriasis and its implications for psychological impairment

Abstract Background: Psoriasis is a systemic auto-inflammatory disease that is related to an increased risk of organic and psychological comorbidities. Type D is a stable personality trait in healthy subjects but there is no data regarding its stability in patients with moderate-severe psoriasis. Objectives: To assess the stability of type D personality in patients with moderate to severe psoriasis as well as assessing the influence of type D personality on anxiety and depression. Methods: Prospective cohort study. Forty psoriasis patients with type D personality and sixtysix patients with psoriasis without type D personality were included in the study. Participants completed the DS14 test and HADS at baseline and four years later. Results: At baseline, the prevalence of type D personality was 37.7% and at week 208 it was 27.3%. The stability of type D personality was higher in patients with an incomplete education level and in those who were separated/divorced or windowed. During follow-up, 15% of patients developed type D personality. Male sex, having topical treatment, the presence of previous depression, anxiety, and high levels of negative affectivity at baseline increase the risk of developing type D personality. Study limitations: Sample size, psoriasis severity restricted to moderate and severe and all patients being under treatment for psoriasis. Conclusion The presence of type D personality varies over time in psoriasis patients. Therefore, type D personality is possibly more a state than a trait phenomenon, modified by environmental factors. Type D personality is associated with a higher risk of anxiety.

Mesotelioma pleural relacionado à exposição ao asbesto: revisão de literatura / Pleural mesothelioma related to asbestos exposure: literature review

RESUMO Mesotelioma pleural é uma doença que acomete a pleura e é definida pela exposição ocupacional ao amianto que constitui seu único fator de risco. Realizar o diagnóstico é um grande desafio para médicos, pelo fato de ser uma doença silenciosa e que se manifesta mesmo anos após a exposição ao mineral. Atualmente, não há definição do melhor tratamento para a doença, há grandes divergências na literatura; deve, portanto, individualizar cada caso. Sabe-se que a terapia multimodal é superior estatisticamente a terapia monomodal de tratamento da doença. Dessa forma, o objetivo do trabalho é revisar artigos que descrevam a doença, a qual relaciona a exposição ocupacional ao asbesto e alternativas globais para diminuir sua incidência; e, por conseguinte, aprimorar o seu tratamento. PALAVRA-CHAVE: Asbestos, mesotelioma, pleura

ABSTRACT Pleural mesothelioma is a disease that affects the pleura and is defined by occupational exposure to asbestos, which is its only risk factor. Diagnosis is a major challenge for physicians, as it is a silent disease that manifests itself years after exposure to the mineral. Currently, there is no definition of the best treatment for the disease, there are great divergences in the literature; it must, therefore, be individualized for each case. It is known that multimodal therapy is statistically superior to monomodal therapy for treating the disease. Thus, the objective of the work is to review articles that describe the disease, which relates occupational exposure to asbestos and global alternatives to reduce its incidence; and, therefore, improve its treatment. KEYWORDS: Asbestos, mesothelioma, pleura

Mesotelioma en paciente colombiano con sobrevida mayor a tres años: presentación de caso / Mesothelioma in a Colombian Patient over three years: Case Presentation / Mesotelioma em paciente colombiano com sobrevivência superior a três anos: apresentação de caso

Resumen Introducción: el mesotelioma epitelioide es un tumor que se desarrolla en las capas embrionarias mesoteliales; es de etiología desconocida, pero se relaciona con la exposición al asbesto, con una presentación clínica inespecífica y con un pronóstico de sobrevida corto después del diagnóstico. Presentación del caso: hombre de profesión mecánico automotor, con tos sin expectoración, disnea, hipertermia y emaciación posterior a la extracción quirúrgica de lipomas que afectaban el tórax, quien posteriormente fue diagnosticado con mesotelioma epitelioide maligno con ubicación en la pleura del hemitórax derecho y fue tratado con toracotomía, quimioterapia con los medicamentos pemetrexed y cisplatino y sesiones de radioterapia, que mostraron un aumento en la sobrevida 3 tres años. Conclusión: este caso permitió identificar que el uso de la pleurodesis química con quimioterapia como tratamiento podría ser responsable del aumento de la esperanza de vida y la calidad de esta en los pacientes que padecen este tipo de tumor.

Abstract Introduction: Epithelioid mesothelioma is a tumor that develops in the mesothelial embryonic layers; it is of an unknown etiology, but it is related to asbestos exposure with a nonspecific clinical presentation and a short survival prognosis after diagnosis. Case presentation: An automotive mechanic patient presents with cough without expectoration, dyspnea, hyperthermia, and emaciation following surgical removal of lipomas. This affected the chest and the patient was subsequently diagnosed with malignant epithelioid mesothelioma located in the pleura of the right hemithorax. The patient was treated with thoracotomy, chemotherapy with the drugs pemetrexed and cisplatin, and radiation therapy sessions which resulted in an increased survival rate at 4 years. Conclusion: This case report identifies the use of chemical pleurodesis in combination with chemotherapy as an effective treatment for increasing the life expectancy and quality of life in patients suffering from this type of tumor.

Resumo Introdução: o mesotelioma epitelióide é um tumor que se desenvolve nas camadas embrionárias mesote-liais; é de causa desconhecida, mas está relacionado com a exposição ao amianto e possui uma manifestação clínica inespecífica e com prognóstico de sobrevivência curto após o diagnóstico. Apresentação do caso: o paciente é um mecânico automotivo, que apresentou tosse seca, dispneia, hipertermia e emagrecimento posterior a extração cirúrgica de lipomas que afetavam o tórax sendo posteriormente diagnosticado com mesotelioma epitelióide maligno localizado na pleura do hemitórax direito e foi tratado com toracotomia, quimioterapia com os medicamentos pemetrexed e cisplatino além de sessões de radioterapia, mostrando um aumento de expectativa de vida para 4 anos. Conclusão: este estudo de caso permite identificar que o uso da pleurodese química com quimioterapia como tratamento poderia ser a responsável pelo aumento da expectativa e qualidade de vida em pacientes acometidos por este tipo de tumor.

Sensibilidade e especificidade dos registros de câncer nas notificações do mesotelioma maligno / Sensibilidad y especificidad de los registros de cáncer en las notificaciones del mesotelioma maligno / Sensitivity and specificity of the reporting of malignant mesothelioma

RESUMO Objetivo: Mensurar a sensibilidade e especificidade das notificações de mesotelioma maligno do Registro de Câncer Base Populacional de Curitiba/Paraná. Método: Estudo retrospectivo, transversal, realizado no registro de câncer de base populacional de Curitiba e em 11 fontes notificadoras, de janeiro a dezembro de 2017. A amostra final foi composta por 92 prontuários de pacientes adultos, com diagnóstico e notificação de registrados com câncer de topografia C38 (pleura, coração e mediastino) e C48 (peritônio e retroperitônio). Para análise da sensibilidade e especificidade utilizou-se o software Stata 14, com análise da consistência interna; para cada caso notificado pelo registro foi examinado o prontuário da fonte notificadora correspondente, considerando-o como padrão ouro. Resultados: A sensibilidade do registro em notificar mesotelioma (CID-10: C45) e câncer de pleura (CID-10: C38.4) foi de 100% (8/8) e 50% (1/2), respectivamente. A especificidade foi 90,2% (74/82), tendo oito casos de outros cânceres classificados como câncer de pleura. Conclusões: O registro apresentou alta sensibilidade para notificar mesotelioma maligno, não havendo subnotificação para esses casos, e uma sobre-estimativa para as notificações de câncer de pleura (nove ao invés de um) devido à notificação errônea e equívoca.

resumen Objetivo: determinar la sensibilidad y especificidad de las notificaciones de mesotelioma maligno del Registro de Cáncer Base Poblacional de Curitiba/Paraná/Brasil. Método: estudio retrospectivo, transversal, realizado en el registro de cáncer de base poblacional de Curitiba y en 11 fuentes notificantes, de enero a diciembre de 2017. La muestra final fue compuesta por 92 registros médicos de pacientes adultos, con el diagnóstico y la notificación de registrados con cáncer de topografía C38 (pleura, corazón y mediastino) y C48 (peritoneo y retroperitoneo). Para el análisis de la sensibilidad y especificidad se utilizó el software Stata 14, con análisis de la consistencia interna. Para cada caso notificado por el registro, fue examinado el registro médico de la fuente que ha notificado, considerándolo como estándar de oro. Resultados: la sensibilidad del registro para notificar mesotelioma (CID-10: C45) y cáncer de pleura (CID-10: C38.4) fue de 100% (8/8) y 50% (1/2), respectivamente. La especificidad fueel90,2% (74/82), con ocho casos de otros cánceres clasificados como cáncer de pleura. Conclusiones: el registro presentó alta sensibilidad para notificar mesotelioma maligno, no existiendo subnotificación para estos casos, y un incremento para las notificaciones de cáncer de pleura (nueve al revés de uno) debido a la notificación incorrecta y equivocada.

ABSTRACT Objective: To measure the sensitivity and specificity of the reporting of malignant mesothelioma in the Population-Based Cancer Registry in Curitiba, PA, Brazil. Method: Retrospective, cross-sectional study conducted in the Population-Based Cancer Registry in Curitiba and 11 reporting institutions, from January to December 2017. The final sample was composed of 92 medical records of adult patients, with diagnoses and reporting of cancer, with topographical codes C38 (pleura, heart, and mediastinum) and C48 (peritoneum and retroperitoneum). Stata 14 was used to analyze sensitivity and specificity, and internal consistency. Each medical record (considered the gold standard) provided by the reporting institutions was compared to those in the registry. Results: The registry sensitivity in reporting mesothelioma (ICD-10: C45) and pleural cancer (ICD-10: C38.4) was 100% (8/8) and 50% (1/2), respectively. Specificity was 90.2% (74/82), as eight cases were wrongly classified as pleural cancer. Conclusions: the registry presented high sensitivity in the reporting of malignant mesothelioma, with no underreporting, and overestimated pleural cancer reporting (nine instead of one) due to erroneous and misleading reporting.

Chinese guideline for clinical diagnosis and treatment of malignant pleural mesothelioma (2021 Edition) / 中华肿瘤杂志

Malignant pleural mesothelioma (MPM) is a pleura-derived malignant tumor, with a gradually increasing incidence in recent years based on domestic and foreign epidemiologic data. Most patients with MPM are diagnosed at an advanced stage due to its insidiousness and aggressiveness. The therapeutic strategies of MPM mainly include surgery, chemotherapy and radiotherapy. Recently, the immunotherapy has altered the treatment pattern and further improved the survival of these patients. In order to timely present the domestic and foreign progress in the diagnosis and treatment of MPM, and to further improve the level of standardized diagnosis and treatment in MPM in China, this guideline was formulated on the basis of existing clinical research evidence combined with experts' opinions. The guideline covers the epidemiology, diagnosis, pathology, treatment and follow-up of MPM.

Caso Clínico: Mesotelioma primario de pericardio / Case Report: Primary Pericardial Mesothelioma / Case Report: Primary Pericardial Mesothelioma

INTRODUCCIÓN: El mesotelioma primario de pericardio (MPP) es un tumor de origen mesodérmico muy raro dentro de las patologías oncológicas; con una incidencia muy baja. Se han descrito aproximadamente 350 casos alrededor del mundo, siendo la mayoría diagnósticos post mortem. El pronóstico es malo a corto plazo, independientemente del tratamiento a instaurarse, siendo este por lo general únicamente paliativo. A continuación presentamos un caso clínico a propósito de esta patología. CASO CLÍNICO: Paciente de 69 años hospitalizado con cuadro de disnea progresiva y anemia severa. En exámenes complementarios de imagen se evidenció derrame pleural y derrame pericárdico. El reporte histopatológico del líquido pericárdico fue positivo para mesotelioma pericárdico. EVOLUCIÓN: Debido a derrame pericárdico recurrente se decidió realizar pericardiectomía más pleurectomía izquierda como tratamiento paliativo, para aliviar la sintomatología del paciente. Se propuso continuar con quimioterapia, sin embargo, el estado general del paciente se deterioró llevando al fallecimiento. CONCLUSIÓN: El mesotelioma primario de pericárdico es un tumor extremadamente raro, cuya clínica se caracteriza por sintomatología asociada al derrame pericárdico, siendo debido a su baja incidencia un diagnóstico difícil. El pronóstico es malo a corto plazo y no se encuentra un protocolo establecido con resultados que mejoren la mortalidad.

BACKGROUND: Primary pericardial mesothelioma is an extremely rare mesodermal tumor, among oncological diseases, with a very low incidence. About 350 cases have been described around the world, most of them diagnosed post-mortem. The short term prognosis is poor, regardless of the treatment, which is mostly palliative. We present a case report regarding this pathology. CASE REPORT: 69 year old patient hospitalized with dyspnea and severe anemia. Complementary workup showed pleural effusion and pericardial effusion. Histopathology report of the pericardial fluid revealed pericardial mesothelioma. EVOLUTION: Due to recurrence of pericardial effusion, it was decided to perform pericardiectomy and left pleurectomy as palliative treatment, to alleviate the patient's symptoms. Chemotherapy was planned after the procedure, but the patient's general condition deteriorated severely leading to his death. CONCLUSION: Primary pericardial mesothelioma is a rare tumor, whose symptoms are characterized by the associated pericardial effusion, making the diagnosis difficult due to it low incidence. The prognosis is poor in short- term, and there isn't an established protocol for the treatment with results that showed improve in mortality.

Permanent diabetes insipidus in a patient with mesothelioma treated with immunotherapy

SUMMARY Checkpoint inhibitors have substantially improved the prognosis for patients with advanced malignancy. Treatment with immunomodulants has the ability to reactivate the immune system against tumor cells, but can also trigger the development of immune-related adverse events that reflects a loss of tolerance of the immune system for self-antigens. Regarding the endocrine system, thyroid and pituitary are the most frequent glands involved; in particular hypophysitis is commonly observed with anti-CTLA4 with a variable impaired anterior pituitary dysfunction (mainly ACTH and TSH dysregulation) while a posterior pituitary dysfunction has been rarely described. A 68-year-old man with a diagnosis of metastatic mesothelioma started in September 2016 first-line treatment with tremelimumab and durvalumab. After 3 cycles he presented sudden onset of polydipsia and polyuria without other symptoms. Diagnostic work-up, including a water deprivation test, established a diagnosis of central diabetes insipidus. Patient started sublingual desmopressin 60 mcg three times a day, that was subsequently increased up to 480 mcg/die. At magnetic resonance imaging the posterior lobe of pituitary gland did not show high signal intensity on T1-weighted images. After regression of diabetes insipidus symptoms under desmopressin, patient restarted cancer treatment and received additional 10 doses without worsening of endocrinological toxicity or further treatment-related toxicities, maintaining the same desmopressin dosage. Posterior pituitary dysfunction has been rarely observed in patients treated with immunomodulants. To our knowledge, this is the first observation of permanent central diabetes insipidus in patients treated with combined immune checkpoint inhibitors (tremelimumab and durvalumab).

Síndrome RS3PE (sinovitis simétrica seronegativa remitente con edema) como manifestación paraneoplásica de mesotelioma: reporte de un caso y revisión de la literatura / Remitting seronegative symmetrical synovitis with pitting oedema as a paraneoplastic manifestation of mesothelioma: A case report and review of the literature

RESUMEN El síndrome RS3PE (sinovitis simétrica seronegativa remitente con edema) fue descrito por McCarty (1985) como una forma benigna de artritis reumatoide de inicio en hombres mayores de 70 arios, con compromiso simétrico y asociada a edema de manos y pies. El enfoque de la poliartritis aguda en el adulto mayor debe incluir el síndrome RS3PE, en el que la pobre respuesta a esteroides y el compromiso multisistémico orientan hacia una naturaleza paraneoplásica, principalmente tumores sólidos (adenocarcinoma gástrico y pancreático), linfomas y leucemias. Se presenta el caso de un paciente con RS3PE como manifestación paraneoplásica de mesotelioma, una manifestación rara en este tipo de tumor.

A B S T R A C T Remitting seronegative symmetrical synovitis with pitting oedema (RS3PO) was described by McCarty (1985), as a benign form of rheumatoid arthritis that onset in men older than 70 years (80% of cases), with symmetrical and associated involvement of oedema of hands and feet. The approach of acute polyarthritis in the elderly should include the RS3PO syndrome, where poor steroid response and multisystem involvement oriented towards paraneoplastic nature, mainly with solid tumours (gastric and pancreatic adenocarcinoma), lymphomas and leukaemia. The case is presented of a patient with RS3PO as a paraneoplastic manifestation of mesothelioma, which is rare in this type of tumour.

Mesotelioma pleural maligno. Actualización sobre diagnóstico y tratamiento / Malignant pleural mesothelioma. Update on diagnosis and treatment

RESUMEN Introducción: El mesotelioma pleural maligno es un tumor maligno primario de la pleura, comúnmente asociado con la exposición al asbesto. Se considera una patología rara y muy agresiva. Objetivo: Realizar una revisión sobre los criterios de diagnóstico y tratamiento actualizados en torno al mesotelioma pleural maligno. Métodos: Se realizó una revisión bibliográfica en fuentes de información disponibles en la Biblioteca Virtual de Salud, de la red telemática Infomed, entre ellas, las bases de datos SciELO, Pubmed/Medline, Cumed, Lilacs, así como el Google Académico. Se seleccionaron un total de 39 referencias. Conclusiones: Existen pocas referencias en la literatura nacional relacionadas con el diagnóstico, tratamiento y seguimiento de los pacientes con mesotelioma pleural maligno. El diagnóstico combina el uso del método clínico, los estudio imagenológicos e histoquímicos. No existe un tratamiento estándar, siendo recomendable un enfoque individualizado que combine según cada caso, cirugía, quimio y radioterapia. Los desafíos futuros incluyen el desarrollo de nuevas alternativas terapéuticas(AU)

ABSTRACT Introduction: Malignant Pleural Mesothelioma is a primary malignant tumor of the pleura, commonly associated with exposure to asbestos. It is considered a rare and very aggressive pathology. Objective: Conduct a review of updated diagnostic and treatment criteria for malignant pleural mesothelioma. Material and Methods: A bibliographic review was made through the search of information in sources available from the Cuban National Health Care Network and Portal (INFOMED), among them, databases such as SciELO, Pubmed / Medline, Cumed, Lilacs, as well as Google Scholar. Finally, a total of 39 references were selected for our study. Conclusions: There are few references in the national literature related to the diagnosis, treatment and follow-up of patients with malignant pleural mesothelioma. The diagnosis combines the use of the clinical method, the imaging and histochemical studies. There is no standard treatment, being recommended an individualized approach that combines according to each case, surgery, chemo and radiotherapy. Future challenges include the development of new therapeutic alternatives(AU)

Primary Cutaneous Solitary Fibrous Tumor on the Back

Solitary fibrous tumors (SFT) are uncommon mesenchymal tumors. SFT have several synonyms including localized fibrous tumor, benign mesothelioma, localized fibrous mesothelioma, and submesothelial fibroma. SFT usually occur in the pleura or other serosal surfaces, but SFT can also develop in extrapleural areas including the nasal cavity, orbit, retroperitoneum, and pelvis. Cutaneous SFT is extremely rare, and more likely to occur in the head and neck region. Histologically, this tumor can mimic a variety of benign and malignant tumors such as dermatofibroma, dermatofibrosarcoma protuberans, spindle cell lipoma or other mesenchymal tumors. Most cases of SFT show non-aggressive clinical courses, with low recurrence rates. Herein, we describe a case of primary cutaneous SFT which presented with huge mass on the back.

Mesotelioma pleural maligno: a propósito de un caso / Malignant pleural mesothelioma: a case report

El mesotelioma difuso es una neoplasia maligna poco frecuente que proviene de las células mesoteliales; la pleura es su localización más habitual y se estima que un 10% de los casos se localizan a nivel peritoneal. El mesotelioma es habitualmente diagnosticado en la quinta década de la vida, con un claro predominio en el sexo masculino, debido esto último a su relación con la exposición laboral al asbesto. Se expone un caso con factores de riesgo y diagnóstico asociado. (AU)

Diffuse mesothelioma is a rare malignant neoplasm that comes from mesothelial cells; the pleura are the most common location and is estimated that 10% of the cases are located at the peritoneal level. Mesothelioma is usually diagnosed in the fifth decade of life, with a clear predominance in the male sex, due to its relation to occupational exposureto asbestos. A case is presented with risk factors and associated diagnosis. (AU)

Asbestos Exposure in Cases of Pleural Mesothelioma in the Argentine Republic / Exposición al asbesto en casos de mesotelioma pleural en la República Argentina

Introduction: Pleural mesothelioma is a rare tumor with a high degree of malignancy. It is considered an occupational disease that has developed in parallel with the industrial use of asbestos. In Argentina, the asbestos was prohibited in 2003. The objective of this study is to know the clinical and diagnostic characteristics and treatment of pleural mesothelioma and to determine the characteristics of asbestos exposure in 40 cases of mesothelioma in different regions of the Argentine Republic. Materials and Methods: It is a descriptive, multicenter study. Hospitals from Buenos Aires, Tucumán, Córdoba and Rosario participated in this study from January 2013 until January 2015. Clinical data were recorded in a Medical Form, and history of environmental, domestic and occupational exposure was recorded in an Exposure Form. Each participant was classified as: exposed, not exposed or unknown. The patient was considered as "exposed" if he/she identified at least one of the three types of exposure: occupational, environmental or domestic. Results: 40 cases of pleural mesothelioma were analyzed, 55% of which were male. We found reference of at least one exposure to asbestos in 75% of the cases; 7.5% denied every possible type of exposure and in 17.5% exposure was unknown. The probability of exposure was: 57.5% environmental, 60% domestic and 37% occupational. There was a greater statistically significant proportion of men with occupational exposure. Conclusion: The contribution of this work relies on the information about the different types of asbestos exposure in cases of pleural mesothelioma in the Argentine Republic.

Exposición al asbesto en casos de mesotelioma pleural en la República Argentina / Asbestos Exposure in Cases of Pleural Mesothelioma in the Argentine Republic

Introducción: El mesotelioma pleural es un tumor poco frecuente de alto grado de malignidad. Es considerada una enfermedad profesional cuyo desarrollo fue paralelo al uso industrial del asbesto. En Argentina, el asbesto fue prohibido en el año 2003. El objetivo de este estudio fue conocer las características clínicas, de diagnóstico y tratamiento del mesotelioma pleural y determinar las características de exposición al asbesto en 40 casos de mesotelioma en distintas regiones de la República Argentina. Materiales y métodos: Se trata de un estudio descriptivo y multicéntrico. Participaron hospitales de Buenos Aires, Tucumán, Córdoba y Rosario desde enero del 2013 a enero del 2015. Se recogieron los datos clínicos en un Formulario Médico y los antecedentes de exposición ambiental, doméstica y laboral en un Formulario de Exposición. Se clasificó a cada participante como expuesto, no expuesto o desconocido. Se consideró expuesto cuando tenían identificado al menos uno de los tres tipos de exposición laboral, ambiental o doméstica. Resultados: Se analizaron 40 casos de mesotelioma pleural, 55% masculinos; encontrando referencia de al menos una exposición al asbesto en el 75% de los casos, el 7,5% negó todas las posibles exposiciones y en el 17,5% la exposición resultó desconocida. La probabilidad de exposición ambiental fue del 57,5%, doméstica del 60% y laboral del 37%. Se encontró mayor proporción de varones con exposición laboral en forma estadísticamente significativa. Conclusión: El aporte del presente trabajo radica en la información sobre los distintos tipos de exposición al asbesto en casos de mesotelioma pleural en la República Argentina.

Synchronous presentation of muscle-invasive urothelial carcinoma of bladder and peritoneal malign mesothelioma

ABSTRACT Introduction Cancer is one of the most important leading cause of death in man and woman in the world. The occurrence of new cancer has become more frequent in recent years due to strict screening protocols and occupational and environmental exposure to carcinogens. The incidence of secondary malignancies has also increased due to close medical follow-up and advanced age. Herein, we report a case and its management diagnosed as synchronous peritoneal malignant mesothelioma and muscle-invasive urothelial carcinoma. Case Description A 71-year-old male presented with macroscopic hematuria and abdominal distension increasing gradually. A contrast enhanced computerized tomography demonstrated bladder mass and diffuse ascites with nodular peritoneal thickening and umbilical mass. He was treated with the multidisciplinary team working including urologist, medical oncologist and general surgeon. Conclusions To our knowledge, this is the first case of peritoneal malign mesothelioma with synchronous muscle-invasive urothelial carcinoma. Because of the rarity of this condition, there is still no consensus on the definitive treatment protocols, yet. Individualized treatment with multidisciplinary close follow-up might improve the survival outcomes.