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Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma is the most aggressive form of this terminal disease, caused by long-ago exposure to asbestos. It’s often resistant to therapy. Patients may not even be given the option of surgery or radiation. In many cases, palliative care is the primary goal.

Sarcomatoid mesothelioma is the least common of the three types of malignant mesothelioma, the other two being epithelial and biphasic.

Some important elements to consider about sarcomatoid mesothelioma:

  • It accounts for 10 to 20 percent of all pleural mesothelioma diagnoses (in the chest cavity) and 4 percent of peritoneal mesothelioma diagnoses (in the abdominal cavities).
  • It is linked to asbestos exposure.
  • It is more resistant to treatment than other mesothelioma cell types.
  • Tumors tend to appear as lesions or nodules, not typically as a localized mass.
  • It is more resistant to treatment than other cell types.
  • Most often found in pleural mesothelioma.
  • Metastases to other major organs is common with sarcomatoid mesothelioma – even occurring at opposite sides of the chest or distant parts of the body.
  • Median survival rate is about 6 months.
  • Palliative care (to make patients comfortable) is the most common treatment.

At The Law Offices of Jeffrey S. Glassman, our mesothelioma lawyers in Boston understand that patients with sarcomatoid mesothelioma have been dealt a devastating blow. Mesothelioma in general has a poor prognosis, and those with sarcomatoid mesothelioma may have very little time to arrange their affairs before the disease claims another victim.

It’s imperative for those with this cellular type of mesothelioma to contact an experienced law firm because while the patient may not survive to see the conclusion of their claims or litigation, these steps can mean financial security for their survivors and loved ones. There is sometimes important evidence in asbestos injury litigation that can be gleaned only from the person who is afflicted, and that’s why it’s critical to act quickly – even it if means there is only time to conduct a single deposition.

What is Sarcomatoid Mesothelioma?

Sarcomatoid tumors most often occur as scattered and spindled, usually forming at the surface of the lining of the lungs.

The tumor is diagnosed by histology, with pathologists examining tissue samples from a biopsy under a slide.

As outlined in, “Guidelines for Pathologic Diagnosis of Malignant Mesothelioma,” published in the journal Archives of Pathology, it’s considered to have the least favorable prognosis and is the most difficult to treat.

It’s also sometimes referred to as “sarcomatous mesothelioma” or “spindled mesothelioma,” owing to its shape, which contains a large, elongated nucleus. In some cases, the cancer even has multiple nuclei. Worse, it’s not always easy to diagnose because it can be difficult to distinguish from healthy cells. The spindle shape is only seen upon careful analysis under a microscope. In many cases, pathologists.

The cells grow in a haphazard pattern, which allows them to spread faster than cellular types of mesothelioma. That’s also what makes it more difficult to treat.

Pre-Disposing Risk Factors for Sarcomatoid Mesothelioma

While we don’t know why some patients with mesothelioma develop the less aggressive epithelial or biphasic versions while others develop sarcomatoid, DoveMed notes the condition is associated with:

  • Asbestos exposure. Most commonly, we see diagnosis of sarcomatoid mesothelioma after years of working with asbestos in occupations such as manufacturing (using products like paints, insulation, floor tiles, ceiling, roofing, etc.), construction (home builders), electricians, firefighters, demolition workers, military veterans, chemical plant workers and shipyard workers.
  • Secondary asbestos exposure. This typically occurs when a family member is exposed to asbestos dust via the clothing or car seats of someone who works directly with asbestos and incidentally transports the fibers.
  • Chronic smoking. Here we should note that while smoking may be associated with higher rates of mesothelioma, there is no definitive evidence that smoking causes mesothelioma. The only proven cause is asbestos exposure. Asbestos defendants have time and again attempted to raise plaintiff’s smoking history as a defense for why they should not be held liable. The reality is you can still pursue compensation from these companies, even if you smoked.
  • Family history of sarcomatoid mesothelioma. Mutations of the BAP1 gene that can make individuals more susceptible to developing mesothelioma can run in families. Here again, it is the gene that causes mesothelioma, but it may make some individuals more prone to developing the disease after being exposed to asbestos.

Asbestos is the most notable risk factor, and it was used widely in so many products throughout the 20th Century for its high heat resistant properties.

It should be noted that it takes years to develop mesothelioma – typically between 20 and 50 years – which is why many sufferers may not immediately recognize the symptoms, which can mimic other less serious conditions.

Symptoms of Sarcomatoid Mesothelioma

The symptoms of sarcomatoid mesothelioma may vary depending on where the tumor is located.

When the sarcomatoid mesothelioma is located in the pleura (chest cavity), we may see symptoms such as:

  • Weight loss
  • Fatigue
  • Shortness of breath
  • Difficulty breathing

In cases where sarcomatoid mesothelioma is found in the peritoneum (abdominal cavity), we may be more likely to see symptoms like:

  • Loss of appetite
  • Nausea
  • Pain of the abdomen
  • Swelling

Because sarcomatoid cells can be different to tell apart from other types of cells, physicians often use a process called immunohistochemistry. This is a technique that involves staining the proteins in cell samples that can make them easier to see under a powerful microscope.

Treatment of Sarcomatoid Mesothelioma

Individuals with sarcomatoid mesothelioma could be limited in their treatment options.

In general, mesothelioma is treated with one or more of the following:

  • Surgery
  • Chemotherapy
  • Radiation

However, sarcomatoid mesothelioma patients are often not candidates for surgery because this type of cancer is very rigid. That means when it attaches itself to the wall of the chest, it can be extremely difficult to remove. In cases where the cancer is peritoneal, the tumor(s) occur around the intestines, and that again can make it very difficult to remove via surgery.

In some cases, doctors may recommend chemotherapy. Sarcomatoid mesothelioma sufferers have seen less success in tumor shrinkage this route than do patients with other forms of the disease, but there are new medical developments happening all the time, so it’s usually worth exploring.

Researchers are hoping that with these continued advances, we’ll see an increased survival rate over the next few years.

Contact the Law Offices of Jeffrey S. Glassman today for a free and confidential consultation.

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