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Understanding Malignant Peritoneal Mesothelioma | Exploring the Epithelioid Type


Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer that affects the lining of the abdominal cavity, known as the peritoneum. It is estimated that MPM accounts for approximately 10% of all mesothelioma cases, with the majority occurring in the pleura (lining of the lungs). While subtypes of MPM exist, including sarcomatoid and biphasic, this article will focus on the epithelioid type, which is the most common and often more responsive to treatment.

This article aims to provide a comprehensive overview of malignant peritoneal mesothelioma, with a specific focus on the epithelioid type. We will explore its causes, risk factors, symptoms, diagnosis, treatment options, prognosis, and current developments in research.

Overview of Malignant Peritoneal Mesothelioma

Malignant peritoneal mesothelioma develops when the mesothelial cells, responsible for protecting internal organs and lubricating the peritoneal space, undergo malignant transformation. This transformation is commonly linked to exposure to asbestos, a fibrous mineral found in many building materials, insulation, and other industrial applications.

Asbestos fibers are inhaled or ingested and can travel through the body, causing damage to the mesothelial cells lining various organs. It can take decades for symptoms to appear, making it challenging to pinpoint the exact cause of MPM. Other risk factors, such as genetics and radiation exposure, have also been suggested but are not yet well understood.

Types of Malignant Peritoneal Mesothelioma


There are three main subtypes of malignant peritoneal mesothelioma: epithelioid, sarcomatoid, and biphasic. The epithelioid type is the most common, accounting for around 60-70% of all cases. Sarcomatoid mesothelioma is less common, making up approximately 10-20% of cases, while biphasic mesothelioma is a combination of both types.

Each subtype has unique characteristics and may respond differently to treatment. The epithelioid type tends to have a slower growth rate and may be more responsive to therapy, while the sarcomatoid subtype is more aggressive and challenging to treat. Biphasic mesothelioma can have varying proportions of both cell types, making it challenging to predict its behavior.

Focus on Epithelioid Type


The epithelioid type of malignant peritoneal mesothelioma is characterized by its cell morphology, resembling epithelial cells, hence the name. Its cells tend to grow in clusters and sheets, forming glandular structures. These structures can often be seen under a microscope and are an essential part of diagnosing this subtype of MPM.

While the epithelioid type typically has a better prognosis compared to other subtypes, the stage of the disease at diagnosis remains a significant predictor of survival. Early detection and treatment are crucial for improving outcomes.

Symptoms and Diagnosis

Symptoms of malignant peritoneal mesothelioma can be vague and non-specific, making it challenging to diagnose. They may include abdominal pain, swelling, weight loss, nausea, and changes in bowel habits. As these symptoms can also be associated with other conditions, it is essential to consult a doctor if they persist or worsen.

Diagnosing MPM often involves imaging tests such as X-rays, CT scans, and MRIs, which can detect any abnormalities in the abdominal area. A biopsy is then performed to confirm the presence of mesothelioma cells. This involves taking a small tissue sample from the affected area and examining it under a microscope.

Treatment Options

Treatment for malignant peritoneal mesothelioma depends on several factors, including the subtype, stage of the disease, and overall health of the patient. The most common treatment options include surgery, chemotherapy, and radiation therapy.

Surgery for MPM aims to remove as much of the cancerous tissue as possible while preserving the function of surrounding organs. In some cases, a combination of surgery and heated intraperitoneal chemotherapy (HIPEC) may be recommended. This involves administering heated chemotherapy directly into the abdominal cavity during surgery to target any remaining cancer cells.

Chemotherapy is used to shrink tumors and slow the progression of the disease. It involves the use of drugs that kill or stop the growth of cancer cells. In some cases, chemotherapy may be administered before or after surgery to improve outcomes.

Radiation therapy uses high-energy X-rays to target and destroy cancer cells. It may be used in combination with other treatments or on its own, depending on the individual’s circumstances.

Clinical trials may also be an option for those with malignant peritoneal mesothelioma. These trials test new treatments or combinations of treatments to determine their effectiveness and safety.

Prognosis and Survival Rates

The prognosis for malignant peritoneal mesothelioma remains poor, with an average survival time of 12-21 months. However, several factors can influence an individual’s prognosis, such as age, overall health, and response to treatment.

Early detection and treatment are key to improving the chances of survival. Unfortunately, many cases of MPM are diagnosed at an advanced stage when treatment options are limited. That is why it is essential to be aware of the risk factors and symptoms and seek medical attention if any concerns arise.

Research and Current Developments

With the increasing incidence of mesothelioma worldwide, researchers are continually looking for ways to improve diagnosis, treatment, and prognosis. Several studies are currently underway, focusing on developing targeted therapies, immunotherapies, and better methods of early detection.

One promising area of research is the use of immunotherapy, which harnesses the body’s immune system to fight cancer. This approach has shown promising results in other types of cancer and is now being investigated for mesothelioma.

Another area of interest is the development of biomarkers, substances that can be measured in the body to indicate the presence or progression of a disease. These biomarkers could potentially be used for early detection and monitoring of malignant peritoneal mesothelioma.


Malignant peritoneal mesothelioma is a rare and aggressive cancer that affects the lining of the abdominal cavity. While it remains a challenging disease to treat, advancements in research have led to improved understanding and treatment options for this condition.

The epithelioid type of malignant peritoneal mesothelioma is the most common and often more responsive to therapy. However, early detection and treatment remain crucial for improving outcomes. It is essential to be aware of the risk factors, such as exposure to asbestos, and seek medical attention if any symptoms arise. With ongoing research and developments, we can hope for better outcomes for those affected by this devastating disease.

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