Evaluation of malignant mesothelioma cases diagnosed in last six years

77 SUMMARY Malignant pleural mesothelioma, is a tumour that is seen rarely, and in its etiology, there exist a number of factors such as asbestos fibers, fibrous zeolite (erionite), radiation and asbestiform minerals. In developing countries asbestos is increasingly used because of economical reasons. A total of 144 cases with MPM, whose examinations and treatments were carried out in our clinic between January 1990 and April 1996, were induced in the study.The patients were assessed for their clinical, radiological and laboratory findings. In addition, the comparison of cases coming from the regions where contact with asbestos was determined previously and those coming from the regions except for these ones was carried out. In addition, the cases coming from the regions where contact with asbestos was not determined were investigated comprehensively. Of the cases, 62 were female and 82 were male, and male/female ratio was found to be 1.3. The mean age was 54.4 in women, 52.9 in men, being 53.6 in all cases. As onset symptoms in the patients, dyspnea (27 %), chest pain (21.5 %) and cough (6.9 %) were seen most frequently. Among laboratory findings, thrombocytosis was seen in 38 %, and sedimentation was found to be remarkably higher in the majority of patients especially in males and females under 50 years. Furthermore, diagnostic methods were studied, and it was determined that, in 49.5 % of cases, the diagnosis was made through closed pleural needle biopsy. It was also determined that MPM diagnosis was made according to clinical and radiological findings in 5.5 % of cases. Although 58.2 % of the cases were from where they had previously direct exposure to asbestos, it was identified that 41.4 % of the cases were from settlement areas where direct exposure to asbestos was not determined. Furthermore when compared with previous studies, an increase in the number of cases was evident especially those from Ergani. In our cases, the mean survival was found to be 12 months in epithelial subtype, 9 months in mixed subtype and 7 months in sarcomatous subtype.78 In conclusion, the ratios as regards the cases coming from the regions where contact with asbestos was not determined are increasing more and more. In these regions, besides contact with asbestos, some other factors that have an important role in the etiology of MPM may be playing a part. We are of the opinion that the matter should be further studied.