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Pleural mesothelioma is the most frequent, its incidence being 9 times higher than the peritoneal mesothelioma. It is more common in men than in women, being the age of onset of symptoms between 50-70 years with a latency period of 20-40 years. In 80% of cases the etiology is exposure to asbestos dust. Other possible causes of mesothelioma are radiation and polio vaccines contaminated with simian virus SV40. The pleural mesothelioma is about 3% of malignant neoplasms of the pleura, and when the diagnosis is made rapidly and its course is invariably fatal, usually during the next two years.
The most common clinical presentation is diffuse chest pain, which occasionally can be pleuritic or radiating to the shoulder accompanied by pleural effusions. Dyspnea, cough, weakness, malaise and fatigue are usually in advanced stages of the disease. In 89% of cases, the abnormal electrocardiogram abnormalities being more frequent sinus tachycardia (42%), ventricular arrhythmias or headphones (17%) and blockage of a branch bundle (30%)
The most common radiographic finding is an irregular opaque at the periphery of the lung, associated with ipsilateral pleural effusion, with evidence of loss of volume, contraction of the hemithorax committed and no shift of the mediastinum to opposite side, despite significant pleural (*) The diagnosis should be suspected when it is pleural thickening surrounding the lung trapping and fixing the mediastinum.
