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Mesothelioma is a rare form of cancer that can develop in different parts of your body. It most commonly affects your lungs and abdominal lining, but it can also affect other areas like your heart and eyes. There are three types: Epithelial , which usually occurs when you inhale small asbestos fibers; sarcomatoid , which happens when you’re exposed to larger asbestos fibers; and peritoneal, which occurs if asbestos fibers reach your abdomen through surgery or another procedure. Usually, mesothelioma symptoms don’t appear until 10 to 50 years after exposure because it takes time for tumors to grow.
Sarcomatoid mesothelioma is the rarest and very difficult to treat variant of the disease’s three major tumor cell types. In comparison to epithelial and biphasic mesothelioma, it is also very tough and resistant to treatment. Breathing in asbestos fibers causes changes in mesothelial cells that can grow into sarcomatoid mesothelioma.
The wors sarcomatoid is the general classification for sarcomatous, spindle or diffuse malignant fibrous mesothelioma. Sarcomatoid cancer cells can merge to form a sheet-like, fibrous mass on the lung’s membrane. Treating the spindle cell variant is very challenging compared to other types of mesothelioma because the cancer cells are resistant to treatment and quickly move from one region of the cells to new areas. Tumors with this cell type shows fibrous and diffuse throughout the inner lining tissues of the lungs, the term for the pleural membrane surrounding the lungs and lining the chest region.
CHARACTERISTICS OF SARCOMATOID MESOTHELIOMA:
The different behaviours of sarcomatoid cells make this type of mesothelioma especially very hard to treat. Doctors who specialize in mesothelioma are able to examine some of these rare cellular traits when viewing tissue samples under a microscope. Spindle cells appear long, oval and spindle-shaped. The center, or nucleus, of sarcomatoid cells is often enlarged and elongated. Some cells may have more than one nucleus.
Nearly all sarcomatoid mesotheliomas are pleural. There are fewer than 30 documented cases of sarcomatoid peritoneal mesothelioma.
CELL SUBTYPES OF SARCOMATOID MESOTHELIOMA:
Epithelial, biphasic and sarcomatoid are the three main cell types of mesothelioma tumors. Within each types, cells may have different behaviours that doctors further classify into subtypes. There are three different hard to see sarcomatoid mesothelioma cell subtypes which includes:
1. Transitional Mesothelioma: This type shows to multiply and spread in ways similar to other sarcomatoid mesotheliomas. It has fat, spindle-shaped cells, which gives doctors insights separate it from other cells.
2. Lymphohistiocytoid Mesothelioma: These tumors contain inflammatory and immune cells. The lymphohistiocytoid type makes up less than 1 percent of all mesotheliomas. Some people with this cancer have a better than average life span.
3. Desmoplastic Mesothelioma: This sarcomatoid subtype is one of the most hard to diagnose. The major part of the tumor shows no discernible pattern of multiplication. Desmoplastic type accounts for almost 5 percent of all mesotheliomas.
NOTICEABLE SIGNS OF SARCOMATOID MESOTHELIOMA:
For the fact that sarcomatoid mesothelioma is almost exclusively seen in the membrane of the lungs, majority of people experience nonspecific respiratory symptoms such as cough and shortness of breath. Noticeable signs include the following:
1. Breath shortness
2. Prolonged hoarseness
3. Constant cough
4. Coughing out blood
5. Blood oxygen levels very low
6. Low iron
7. Weight loss and tiredness
8. Chest pain or abdominal fullness
9. Lack of appetite, anorexia and nausea
10. Fatigue and extreme weakness.
People suffering from sarcomatoid mesothelioma also commonly feel chest pain prior to diagnosis. As the ailment progresses, signs become more pronounced. It is very sacrosanct to visit and talk to a doctor about any history of first or possible secondhand asbestos exposure and signs as soon as possible.
SARCOMATOID MESOTHELIOMA DIAGNOSIS:
Most unfortunately, malignant mesothelioma are often misdiagnosed because symptoms of the ailment looks alike and less severe conditions.
According to a research carried out in 2018 which shows a new method for a very accurate sarcomatoid malignant mesothelioma diagnosis. Carrying out laboratory experiments for the BAP1 and MTAP genes were 100 percent correct for differentiating sarcomatoid mesothelioma from fibrous pleuritis. However, because genetic material laboratory experiments for mesothelioma needs further clinical trials before widespread adoption, most physicians still prefer traditional diagnostic methods.
SARCOMATOID MESOTHELIOMA MISDIAGNOSIS:
Doctors who does not have much experience with sarcomatoid mesothelioma always tend to misdiagnose the ailment as other types of thoracic or lung cancer.
MAJOR MISDIAGNOSES INCLUDE:
1. Pleural liposarcoma
2. Fibrous pleurisy or pleuritis
3. Sarcoma or fibrosarcoma
4. Malignant fibrous histiocytoma (also called undifferentiated pleomorphic sarcoma)
5. Localized fibrous tumors
6. Metastasized renal cell carcinoma
7. Solitary fibrous tumor of the pleura (hemangiopericytoma).
Looking out for other suggestions from a mesothelioma specialty team is critical for sarcomatoid patients because this group will include pathologists skilled in this diagnosis. Some of the diagnosis methods include the following:
1. Imaging Scans:
As part of the initial diagnostic procedure, doctors rule out causes of ongoing symptoms using physical exams and in-office testing. Then, they will order imaging studies such as X-rays, CT scans or MRIs. These tests reveal abnormalities in the chest, but they do not show specific details such as cell type.
If your imaging studies suggest cancer, your doctor will refer you for a biopsy where a surgeon collects a small tumor sample for analysis and identification under a microscope. Depending on the type of biopsy, physicians can obtain tumor tissue samples using a needle under CT scan guidance or in an outpatient procedure with anesthesia. Surgeons often use thoracoscopy or video-assisted thoracic surgery procedures to biopsy mesothelioma. These techniques result in high-quality tissue samples that can increase the chances of an accurate diagnosis.
Specific tests called immunohistochemistry reveal the cancer cell type and stage from a biopsy. Immunohistochemistry involves staining the cells using antibodies that attach to antigens on the tumor. This method indicates to pathologists whether the cancer is benign or malignant. These protein markers include calretinin, podoplanin, D2-40 and pan-cytokeratin.
SARCOMATOID MESOTHELIOMA PROGNOSIS:
Majorly, the life span for many people with sarcomatoid mesothelioma varies from 4 to 18 months with proper treatments. Without proper treatments, the major life span for people with sarcomatoid tumors is usually less than 6 months.
Each patient’s prognosis differs based on the stage and location of the cancer and overall patient health. Sarcomatoid cells are notoriously resistant to treatment because of their fibrous nature. Current treatments, however, have helped several patients with the lymphohistiocytoid cell subtype survive for up to four years, and one documented patient remained alive without symptoms 12 years after his diagnosis.
It’s important to note that doctors use past data to make prognosis estimates. As treatment options improve and newer, cutting-edge therapies are employed, prognosis typically improves as well. Current survival rate statistics don’t take this most recent data into account.
Clinical trials offer the best chance at improving prognosis and are available at specialized centers. Patients interested in the newest available therapies should seek treatment at a specialty mesothelioma treatment facility.
AVAILABLE TREATMENTS FOR SARCOMATOID MESOTHELIOMA PATIENTS:
The best mesothelioma treatment options for the sarcomatoid cell type include immunotherapy, chemotherapy, targeted therapy and radiation therapy. Patients should seek care from a mesothelioma specialist because sarcomatoid mesothelioma is harder to treat than the epithelioid or biphasic cell types. Surgeons generally do not operate on patients with this type of mesothelioma because sarcomatoid cancer cells tend to return within a few months of the procedure. There is currently no cure for sarcomatoid or any other variant of mesothelioma. Treatment can improve cancer symptoms, extend survival and increase quality of life for many patients.