Biphasic Mesothelioma

Biphasic Mesothelioma | Diagnosis, Symptoms, & Treatments
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Biphasic mesothelioma, a specific variant of mesothelioma, emerges as a consequence of asbestos exposure. It constitutes approximately 20% of all mesothelioma cases and is distinguished by the presence of both epithelioid and sarcomatoid cells within the tumor tissue. A definitive diagnosis of biphasic mesothelioma requires that the tumor comprises at least 10% of both epithelioid and sarcomatoid cells.

Cellular Composition

To elucidate, if a tumor comprises 90% epithelioid and 10% sarcomatoid cells, it falls into the biphasic mesothelioma category. Conversely, when a tumor primarily consists of 93% sarcomatoid and 7% epithelioid cells, it is classified as sarcomatoid mesothelioma. The predilection of biphasic mesothelioma is for the pleura (lung linings) and peritoneum (abdominal lining), with occasional occurrences in the pericardium (heart lining) and tunica vaginalis (testes). The cellular pattern in biphasic mesothelioma is contingent on the proportion of epithelioid and sarcomatoid cells, each bearing distinct characteristics.

Biphasic Mesothelioma Symptoms

Biphasic mesothelioma, akin to other mesothelioma subtypes, tends to remain latent for decades following asbestos exposure. Symptoms materialize based on the cancer’s location. Pleural biphasic mesothelioma often manifests symptoms related to the lungs, such as chest pain, pleural effusion, pleural plaques, pleural thickening, and dyspnea (shortness of breath). In cases of peritoneal biphasic mesothelioma, patients may experience abdominal pain, abdominal swelling, and weight loss. Furthermore, patient-specific factors, including overall health, age, and pre-existing conditions, can influence symptom presentation.

The Diagnostic Process

The diagnostic process for biphasic mesothelioma typically commences with general physical examinations and imaging studies such as X-rays or CT scans. In the event of discernible tumors or excessive fluid accumulation, a biopsy becomes imperative. Biopsy results serve to definitively diagnose biphasic mesothelioma and distinguish it from other conditions with overlapping symptoms. Blood tests may also be conducted to identify specific biomarkers associated with mesothelioma. It is imperative to note that a biopsy sample must contain at least 10% of both epithelial and sarcomatoid cells to corroborate a biphasic mesothelioma diagnosis.

Treatment Options

Treatment options for biphasic mesothelioma include chemotherapy, immunotherapy, and occasionally combination or multimodal approaches. The selection of treatment depends on various variables, including the cancer’s location, the patient’s overall health, the percentage of sarcomatoid cells, and disease severity. While chemotherapy and radiation exhibit limited efficacy against sarcomatoid cells, they may enhance life expectancy in epithelioid mesothelioma cases. Surgical interventions, such as cytoreductive surgery (CRS) coupled with heated intraoperative chemotherapy (HIPEC), have demonstrated efficacy for peritoneal biphasic mesothelioma. Immunotherapy, notably, has shown promise in the treatment of biphasic pleural mesothelioma patients.

Prognosis for Biphasic Mesothelioma

Prognostic outcomes for biphasic mesothelioma are variable, with a survival duration spanning approximately 1 to 3 years. The prognosis is closely linked to the specific cellular composition of the tumor (the equilibrium between epithelioid and sarcomatoid cells), the cancer’s stage, and the effectiveness of the chosen treatment regimen.

Biphasic mesothelioma represents a distinct mesothelioma subtype characterized by its unique cellular composition. Understanding its nature, symptomatology, diagnostic process, and available treatment modalities is vital for both patients and healthcare professionals involved in managing this condition.