Mesothelioma is a rare type of cancer which can occur in various sites, such as the peritoneum, the pericardium and tunica vaginalis testis; but malignant pleural mesothelioma is the most common type. Malignant pleural mesothelioma commonly affects older males that have been exposed to asbestos 20-40 years ago. The disease is difficult to be treated and has an overall survival expectancy of about 1 year. Histological subtypes include epithelioid, sarcomatoid and biphasic or mixed. Diagnosing this type of cancer is rather challenging and as a result it is usually diagnosed in most patients in progressed stages. Surgery with minimal procedures is applied to reach the diagnosis, with the Video Assisted Thoracoscopic procedure being considered to be the “gold standard”. Patients with malignant pleural mesothelioma should be managed by experienced multidisciplinary teams, as treatment options include surgery, radiation therapy and /or chemotherapy. Extrapleural pneumonectomy and pleurectomy/decortication are the preferred procedures in the treatment of this malignancy, but whether they prolong life expectancy or improve quality of life of the patients still remains a controversial issue. In any case, careful assessment before surgery is of paramount importance. Multimodality approaches, which include surgery for patients who are fit, are often chosen in order to increase survival rates in clinical trials.
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