Rare Localizations of Mesothelioma

Abstract

Malignant mesothelioma (MM) commonly occurs in the pleura and peritoneum but also arises rarely from the mesothelial cells at other anatomical sites, such as pericardium, Glisson’s capsule, and tunica vaginalis testis (TVT). These rare localizations of MM account for less than 1% of all MMs. Due to the rarity of these malignancies, it is difficult to obtain specific information about their incidence, natural history, and pathogenesis. An etiological role of asbestos exposure has been hypothesized but its association with these rare MM localizations is still discussed because of the absence of analytical case-control epidemiological studies.

The National Comprehensive Cancer Network evidence-based cancer guidelines made no recommendations for their management. Their clinical presentations are non-specific, thus the diagnosis is established post-operatively or at post-mortem examination. There is no standard of care. The treatment of these rare MMs mimics one of the more common pleural and peritoneal presentations without solid evidences in literature. Indeed systematic review shows only case reports and series of cases for these localizations.