Desmoplastic mesothelioma, also known as desmoplastic sarcomatoid mesothelioma, is a malignant form of mesothelioma cancer that is both rare and life-threatening. This type of mesothelioma occurs in less than 10% of confirmed mesothelioma cases and is a sub-type of sarcomatoid mesothelioma, though it may also appear in biphasic mesothelioma cases where both sarcomatoid and epithelioid cell types are discovered. Desmoplastic mesothelioma is specifically characterized by the presence of connective tissues in the mesothelioma tumor, a type of tissue that is normally absent from mesothelioma cancer.
Desmoplastic Mesothelioma Symptoms
The mere presence of connective tissues within the tumor does little, if anything, to change to overall symptoms of malignant mesothelioma. Desmoplastic mesothelioma symptoms are the same as more common types of malignant mesothelioma and are dependent on the stage of the cancer, the location of the cancer, and the patient’s overall health. Just like other forms of mesothelioma, the symptoms of cancer aren’t always apparent in earlier stages of the disease.
The general symptoms of desmoplastic mesothelioma begin to appear in later stages of the disease and are specific to the location of the tumors.
If desmoplastic mesothelioma occurs in the pleura that lines the lungs and chest walls, the patient may exhibit the following symptoms:
- Pleurisy (pain when breathing or difficulty breathing)
- Chest Pain
- Dry, sometimes painful, coughing
- Breathlessness or shortness of breath (dyspnea)
- Difficulty swallowing
- Fatigue, lethargy and weakness
- Back Pain
- Unexplained\unplanned weight loss
- Fever\Sweating
- Hoarse voice
- Swelling in the face, arms, neck (upper extremities)
If desmoplastic mesothelioma occurs in the peritoneum that lines the organs in the abdomen and abdominal walls, the patient may exhibit the following symptoms:
- Pain
- Fatigue\Anemia
- Weight Loss
- Fever and Sweating
- Nausea and Vomiting
- Bowel Movement Changes or Incontinence
- Lumps and Bumps on the abdominal wall
If desmoplastic mesothelioma occurs in the pericardium that surrounds the heart, the patient may exhibit the following symptoms:
- Irregular Heart Beat
- Pain in the Chest
- Heart Murmurs
- Fatigue\Weakness
- Fever, Chills, and Sweating
- Labored or difficult breathing, even when not physically active
- Shortness of breath that is worse when lying down
Desmoplastic Mesothelioma Diagnosis
Desmoplastic mesothelioma is diagnosed during a biopsy procedure, which is a normal component of a general mesothelioma diagnosis. Biopsy is the process of retrieving several tissue samples from the site of the tumor which are later examined closely under a microscope. In order for a diagnosis of desmoplastic mesothelioma to be made, the biopsy examination must indicate the presence of a sarcomatoid type cell that contains connective tissues. Most often, desmoplastic mesothelioma is only present when the patient has a condition known as “dense collagenized stroma”. Dense collagenized stroma occurs when at least half of a normal tissue structure is replaced with collagen.
Sarcomatoid cells occur in approximately 15% of malignant mesothelioma cases and are thought to be the result of prolonged cell exposure to asbestos fibers. Sarcomatoid cells viewed under a microscope appear to be elongated ovals or spindle shaped cells without a defined nucleus. Desmoplastic mesothelioma cells make mesothelioma easy to spot because there are so few possible conditions with this cell type.
Sarcomatoid cells are one of two possible cell types associated with malignant mesothelioma. The other type is “epithelioid cells”, which are the most commonly discovered cells in mesothelioma cases. Some tumors contain both epithelioid cells and sarcomatoid cells. These are known as biphasic types of mesothelioma. Any time sarcomatoid cells are present, whether alone or in a biphasic tumor, there is a possibility of desmoplastic mesothelioma cells.
Desmoplastic Mesothelioma Treatment
Treatment options for desmoplastic mesothelioma do not differ much from the procedures indicated for other types of mesothelioma cancer. There are treatments available to help clear the body of cancer, therapies that limit the patient’s discomfort, and alternative modalities for emotional and mental well-being.
| Desmoplastic Mesothelioma Treatment Options |
|---|
| Curative Mesothelioma Therapy |
| Procedure or Treatment | Purpose of Mesothelioma Therapy |
| Surgery | Surgery performed to remove cancer cells from the body. |
| Pleurectomy or Peritonectomy | Remove all or part of affected the mesothelium. |
| Pneumonectomy | Remove an entire lung that is affected by wide-spread cancer |
| Extrapleural Pneumonectomy | Remove an entire lung and other nearby affected structures. |
| Tumor Resection | Removal of cancer cell clusters (tumors). |
| Chemotherapy | Destroy cancer cells using chemical medications |
| Radiation | Destroy cancer cells with generalized radiation. |
| Brachytherapy | Destroy cancer cells with targeted radiation. |
| Immunotherapy | Manipulate or enhance natural immune system to inhibit cancer cell growth. |
| Gene Therapy | Change the genetic makeup of cancer cells so that they destruct themselves. |
| Photodynamic Therapy | Destroy cancer calls with light sensitive medicines. |
| Complementary Mesothelioma Therapy |
| Surgery | Surgery performed to alleviate pain and discomfort. |
| Tumor Resection | Alleviate pleurisy and other chest pain, remove pressure on nerves that cause pain, remove tumors that are applying pressure to the esophagus or blood vessels that result in the swelling of the throat causing dry cough or difficulty swallowing, remove causes for shortness of breath. |
| Pain Medication | Alleviate pain caused by mesothelioma, surgery, and other treatments. |
| Antibiotics | Reduce and eliminate infection that may be causing fever or pain as a result of a curative mesothelioma therapy or immune deficiency caused by cancer. |
| Lozenges and Cough Medications | Relieve the symptoms of dry cough caused by tumors applying pressure to esophagus or as a result of a treatment. |
| Correcting Nutritional Intake | To relieve fatigue as a symptom of cancer or as a side effect of chemotherapy and radiation, or to treat weight loss that is the result of cancer or a curative treatment. |
| Pleurodesis | To relieve the symptoms of a pleural effusion with medications that obliterate the pleural space, making it impossible for fluids to build up and cause more pain or shortness of breath. |
| Alternative Mesothelioma Therapy |
| Acupuncture | To relieve pain, nausea, muscle tension, and stress |
| Aromatherapy | To relieve nausea, stress, anxiety, and depression |
| Massage | To relieve pain, muscle tension, and stress |
| Prayer and Meditation | To relieve muscle tension, stress, worry, anxiety, and depression |
| Breathing Control | To relieve pain associated with breathing, muscle tension, stress, and anxiety |
The decisions regarding treatment plans for desmoplastic mesothelioma are weighed against the stage of the cancer, the patients overall health, and tolerance for the type of treatment. The prognosis for desmoplastic mesothelioma is poor as with other types of malignant mesothelioma. Many patients have 5 to 8 months cited on the life expectancy portion of the outlook. Stage, response to treatment, and general health are the major factors in extending the initial life-expectancy.
