malignant visceral pleura tumor

Malignant Visceral Pleura Tumors: An Overview

Malignant tumors originating from the visceral pleura are a type of cancer that affects the lining of the lungs. These tumors can be aggressive and have a poor prognosis.

• Incidence: Malignant visceral pleura tumors are relatively rare, but they can account for up to 20% of all pleural tumors (1).
• Characteristics: On imaging studies, malignant visceral pleura tumors appear as soft tissue pleural-based neoplasms with well-circumscribed borders (2). They are often larger than 10 cm in diameter and may be partially encapsulated (3).
• Symptoms: These tumors can cause symptoms due to their mass effect on surrounding structures. However, they are generally slow-growing and may not cause significant symptoms until they have grown significantly (4).
• Prognosis: The prognosis for malignant visceral pleura tumors is generally poor, with a high likelihood of recurrence and metastasis (5-7).

Visceral Pleural Invasion

Visceral pleural invasion (VPI) refers to the infiltration and penetration of tumor tissue through the elastic layer of the visceral pleura. This is an important prognostic factor for malignant visceral pleura tumors, as it indicates a more aggressive disease course (8-10).

References:

(1) Context result 1 (2) Context result 1 (3) Context result 3 (4) Context result 4 (5) Context result 5 (6) Context result 6 (7) Context result 7 (8) Context result 8 (9) Context result 9 (10) Context result 10

Malignant visceral pleural tumors, also known as pleural mesothelioma or malignant pleural effusion, can be challenging to diagnose in their early stages due to non-specific symptoms. However, here are some common signs and symptoms associated with this condition:

Early Symptoms:

1. Chest pain: A dull, aching, or sharp pain in the chest that worsens with deep breathing, coughing, or movement.
2. Shortness of breath: Difficulty breathing, feeling winded even when sitting still, or experiencing shortness of breath during physical activity.
3. Fatigue: Feeling extremely tired or weak, even after resting.
4. Weight loss: Unintentional weight loss due to decreased appetite or difficulty swallowing.
5. Coughing: A persistent cough that produces mucus or blood.

Advanced Symptoms:

1. Difficulty speaking: Swallowing problems (dysphagia) or hoarseness, making it hard to speak or swallow food and liquids.
2. Abdominal pain: Pain in the upper abdomen, which can radiate to the back or chest.
3. Nausea and vomiting: Feeling queasy or experiencing vomiting due to fluid buildup in the lungs or stomach.
4. Fever: Recurring fever, often accompanied by chills or night sweats.
5. Clubbing of fingers and toes: A condition where the tips of the fingers and toes become enlarged and rounded.

Other Possible Symptoms:

1. Pleuritic chest pain: Pain that worsens with deep breathing or coughing.
2. Hemoptysis: Coughing up blood or rust-colored sputum.
3. Cyanosis: A bluish discoloration of the skin, lips, or nails due to inadequate oxygen supply.
4. Pulmonary embolism: Blood clots in the lungs that can cause sudden shortness of breath, chest pain, or coughing.

Keep in mind that these symptoms can be non-specific and may resemble those of other conditions, such as pneumonia, lung cancer, or heart disease. If you're experiencing any of these symptoms, it's essential to consult a healthcare professional for an accurate diagnosis and treatment plan.

Based on the provided context, it appears that there are various treatment options for malignant visceral pleural tumors, including drug treatments.

Chemotherapy

According to search result [5], chemotherapy is a common treatment option for malignant pleural mesothelioma (MPM), which is a type of cancer that affects the pleura. The recommended chemotherapy regimen includes pemetrexed/platin-based chemotherapy, administered pre- or post-operatively in combination with other treatments.

Targeted Therapy

Search result [7] mentions bevacizumab combined with cisplatin as a treatment option for malignant pleural effusion in patients with non-small cell lung cancer (NSCLC). Bevacizumab is a targeted therapy that inhibits angiogenesis, which can help slow down tumor growth.

Adjuvant Chemotherapy

Search result [8] suggests that adjuvant chemotherapy should be explicitly considered for patients with stage IB non-small cell lung cancer and visceral pleural invasion. This treatment approach may improve overall survival in these patients.

Other Treatment Options

While not specifically mentioned as a drug treatment, search result [13] discusses pleurodesis, which involves the administration of a drug or material in the pleural space to cause adhesions between the parietal and visceral pleura. Talc is the most widely used pleurodesis agent.

Median Survival

Search result [15] notes that median survival after diagnosis of an MPE (malignant pleural effusion) is 4 months, indicating a poor prognosis for patients with this condition.

In summary, while there are various treatment options available for malignant visceral pleural tumors, chemotherapy and targeted therapy appear to be the most commonly discussed drug treatments in the provided context. However, it's essential to consult with a healthcare professional for personalized advice on the best course of treatment.

References:

[5] Kindler HL (2018) Recommendation 5.4: In the context of multimodality treatment, four to six cycles of pemetrexed/platin-based chemotherapy may be administered pre- or post-operatively in combination with other treatments. [7] Bevacizumab combined with cisplatin as a treatment option for malignant pleural effusion in patients with non-small cell lung cancer (NSCLC). [8] Adjuvant chemotherapy should be explicitly considered for patients with stage IB non-small cell lung cancer and visceral pleural invasion. [13] Pleurodesis involves the administration of a drug or material in the pleural space to cause adhesions between the parietal and visceral pleura. [15] Median survival after diagnosis of an MPE (malignant pleural effusion) is 4 months.

The differential diagnosis of malignant visceral pleural tumors involves considering various types of cancers that can affect the pleura, a thin layer of tissue surrounding the lungs and lining the chest cavity.

Common Malignant Pleural Tumors

• Metastatic Carcinoma: This is the most common type of malignant pleural tumor, often originating from lung cancer (35-45% of cases), breast cancer, lymphomas, ovarian carcinoma, and other malignancies [5].
• Malignant Mesothelioma: A rare but aggressive cancer that affects the pleura, typically associated with asbestos exposure [7].
• Sarcomas: Rare types of cancer that can affect the pleura, including synovial sarcoma (SFTs) which may be benign or malignant in approximately 10-20% of cases [6].

Other Malignant Tumors

• Carcinomas and Sarcomas: A broad spectrum of carcinomas and sarcomas can metastasize to the pleura, including but not limited to:
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Small cell carcinoma
  • Melanoma
  • Lymphomas (e.g., Hodgkin's lymphoma)
• Pleural Effusion: A condition characterized by the accumulation of fluid in the pleural space, which can be caused by various conditions, including malignancies [3].

Key Features

• Malignant pleural tumors often present with symptoms such as chest pain, shortness of breath, and coughing.
• Imaging studies (e.g., CT scans, MRI) are essential for diagnosing malignant pleural tumors.
• Biopsy and histopathological examination are crucial for confirming the diagnosis.

References

[3] Context: Malignant pleural effusions (MPE) are secondary to lung cancers, breast cancers, and lymphomas in about 70% of cases [3]. [5] Context: Metastatic carcinoma is the most common type of malignant pleural tumor, often originating from lung cancer (35-45% of cases), breast cancer, lymphomas, ovarian carcinoma, and other malignancies [5]. [6] Context: SFTs may be benign or malignant in approximately 10-20% of cases [6]. [7] Context: Malignant mesothelioma is a rare but aggressive cancer that affects the pleura, typically associated with asbestos exposure [7].