Mesothelioma Misdiagnosis

Why Is Mesothelioma Misdiagnosed?

Malignant mesothelioma is often misdiagnosed because its symptoms are not specific to this rare form of cancer. With fewer than 3,000 new cases of mesothelioma reported annually, most doctors have limited experience with mesothelioma and tend to suspect other more common conditions first. 

Patients may experience a range of symptoms, such as shortness of breath, chest pain or abdominal pain, depending on the location of tumors. These nonspecific symptoms make it difficult for doctors to accurately diagnose mesothelioma early. Without thoroughly investigating a patient’s history of asbestos exposure, doctors may misdiagnose another condition. 

Accurately diagnosing malignant mesothelioma requires a team of doctors familiar with this aggressive cancer. Most physicians and oncologists have rarely or never encountered mesothelioma. They may not understand its complexities or how to treat it. Because mesothelioma can resemble other common conditions, a surgical biopsy is necessary for an accurate diagnosis. 

Common Misdiagnoses of Pleural Mesothelioma

Pleural mesothelioma, which develops in the lining of the lungs, is often mistaken for other more common respiratory conditions. Patients may initially show shortness of breath, a dry cough or chest pain. These symptoms also resemble emphysema and pneumonia, making it difficult to distinguish it from other respiratory conditions when symptoms first appear. 

Pleural mesothelioma can also cause pleural effusion — a buildup of fluid around the lungs — and difficulty breathing. Other chronic lung diseases, infections and lung cancer can all show similar symptoms. These may complicate the diagnostic process and lead to a misdiagnosis of mesothelioma.

According to a 2023 study in the Journal of Thoracic Oncology, approximately 14% of mesothelioma diagnoses in higher-resource countries are initially incorrect. In developing countries, this misdiagnosis rate rises to approximately 50%. Initial misdiagnosis can happen because symptoms mimic those of other common conditions, leading pathologists and doctors with limited experience diagnosing mesothelioma to initially suspect other illnesses. 

Approximately one-third of women diagnosed with pleural mesothelioma have initially been misdiagnosed with ovarian cancer. Pleural mesothelioma can cause elevated levels of cancer antigen 125, a blood protein also associated with ovarian cancer. The range of nonspecific symptoms make it easy for doctors to initially suspect other common conditions. A correct diagnosis requires the expertise of a mesothelioma specialist and a biopsy of the patient’s tissue.

Common Misdiagnoses of Peritoneal Mesothelioma

Peritoneal mesothelioma, found in the lining surrounding the abdominal organs, is often mistaken for other abdominal conditions. Symptoms such as abdominal pain and digestive issues overlap with conditions like irritable bowel syndrome, gallstones and other forms of abdominal cancer, complicating the early and accurate diagnosis of peritoneal mesothelioma.

A 2021 study from BMC Gastroenterology highlighted an example of a peritoneal mesothelioma misdiagnosis involving a man with previous asbestos exposure. He had a rare case of benign multicystic peritoneal mesothelioma initially misdiagnosed as hydatid cysts found in the liver and abdominal cavity. He initially presented with generalized abdominal and bloating, and imaging showed he had many cystic formations filled with clear fluid. The patient did not respond to initial treatment, causing the doctors to pursue further testing. 

The nonspecific symptoms of peritoneal mesothelioma make it difficult to distinguish from various abdominal conditions. If you have a history of asbestos exposure and are experiencing common mesothelioma symptoms, it is important to find a mesothelioma specialist. These specialists perform a biopsy to confirm a peritoneal mesothelioma diagnosis and develop a personalized treatment regimen to fit your needs.

Common Misdiagnoses of Pericardial Mesothelioma

Pericardial mesothelioma, an exceptionally rare form of mesothelioma, affects the sac surrounding the heart, known as the pericardium. This type of mesothelioma often leads to pericardial effusion — a buildup of fluid around the heart. It can manifest as chest pain and other cardiac-related symptoms, making it difficult to diagnose early.

In a 2023 case report, a female patient presented with pericardial calcification, a condition where calcium deposits form in the sac around the heart. This initially led to a diagnosis of constrictive pericarditis, but after careful examination of her CT scans and a surgical biopsy, doctors were able to diagnose her correctly with an unusual form of primary pericardial mesothelioma (PPM).

Diagnosis of mesothelioma requires a biopsy to collect tissue samples for laboratory analysis. While blood tests, X-rays and CT scans can help rule out other conditions, they alone cannot accurately diagnose pericardial mesothelioma. A history of asbestos exposure can guide doctors in selecting diagnostic tests that ensure an accurate diagnosis. 

How Can a Mesothelioma Misdiagnosis Affect You?

Misdiagnosing mesothelioma can lead to incorrect or delayed treatment, which can be fatal. Mesothelioma is an aggressive form of cancer, so delayed treatment can allow it to spread to other parts of the body. The more advanced the cancer becomes, the more difficult it is to treat. 

Misdiagnosis also increases the financial burden on mesothelioma patients and their families. Because its symptoms mirror other common conditions, patients may endure extensive tests and procedures before receiving an accurate diagnosis. These medical exams can quickly become expensive but provide little or no relief for the patient’s symptoms. 

Early detection and accurate diagnosis is essential to improve treatment outcomes. Thoracic surgeon Dr. Farid Gharagozloo explained, “Early mesothelioma detection leads to simpler therapies and better survival.” 

A late diagnosis can worsen the prognosis and limit the treatment options available for mesothelioma. Patients and their families should be aware of the symptoms of mesothelioma and seek out a specialist if there is a history of asbestos exposure.

Survivor Story

Survivor Story

Tamron Little Peritoneal Mesothelioma

Survivor’s Early Misdiagnosis Delayed Treatment

Getting an accurate diagnosis wasn’t easy. They said I had a fibroid tumor and that it would go away on its own. The doctors all told me, “You will be fine. It’s normal in African American women.” A tumor attaching itself to the lining of my stomach was normal? After months of taking birth control to shrink it, which didn’t work, I was later diagnosed with peritoneal mesothelioma.

Read Tamron’s Story

How Do Specialists Diagnose Mesothelioma?

Mesothelioma specialists diagnose the disease through a biopsy of the suspected tissue. A pathologist will examine the tissue sample to check for cancer cells. If cancer cells are present, the pathologist will determine if the tumor is mesothelioma and identify the stage based on how far the cancer has spread.

Doctors may also run imaging tests, such as X-rays, CT scans and MRI scans, to spot any abnormalities and rule out other conditions. While these images can provide helpful information, a biopsy is the only way to definitively diagnose mesothelioma. 

Accurate and early diagnosis of mesothelioma is crucial, especially as treating the disease in its advanced stages can be complicated. Specialists have made advances in identifying biomarkers, such as familial BAP1 germline mutations, that show promise for early diagnosis. Researchers are also exploring innovative noninvasive techniques, such as sampling volatile organic compounds in the breath, for early identification of pleural mesothelioma markers. Although this research is still in its early stages, finding techniques to reduce initial misdiagnosis of mesothelioma should improve patient prognosis. 

Mesothelioma can be indistinguishable from other cancers without a proper biopsy. Because the symptoms of mesothelioma are nonspecific, mesothelioma cannot be diagnosed based on symptoms alone. If a patient is not responding to treatment for other common conditions, they should consult a specialist and seek additional testing. A team of mesothelioma experts can assess for exposure to asbestos and use their experience to provide patients with an accurate diagnosis.

If you suspect you have been misdiagnosed, it is crucial to seek a second opinion from a mesothelioma specialist. Mesothelioma is easy to confuse with other conditions, and patients are often misdiagnosed when they first seek medical attention. If you have a history of asbestos exposure or you are not responding to treatment for other conditions, seek additional help.

Mesothelioma is an aggressive form of cancer. Delayed treatment can allow the cancer to spread throughout the body and limit mesothelioma treatment options. A mesothelioma specialist could assist with accurate early detection and provide you with more treatment options. If you’re concerned about the possibility of mesothelioma, there are experts across the country who have years or decades of experience working with mesothelioma patients and can provide you with a mesothelioma second opinion.

Getting a Second Opinion After a Mesothelioma Diagnosis 

People diagnosed with mesothelioma should seek a second opinion from an expert. This includes having a pathologist with mesothelioma experience to confirm the diagnosis and working with a specialist to create a personalized treatment plan. 

Patients diagnosed in the early stages usually qualify for more aggressive treatment options, which have a higher chance of extending life expectancy for mesothelioma. A second opinion may prevent you from getting the wrong diagnosis and treatment, confirm your original diagnosis or simply give you peace of mind.

Patient Advocates at The Mesothelioma Center can help you find the right mesothelioma specialist for your unique needs. When you connect with a Patient Advocate, they will talk to you about your specific needs and find you the right specialist as well as additional resources for you and your family. With their extra support, you can find the right doctor to provide you with a second opinion on your symptoms.  

If you know you have a history of asbestos exposure or have worked in an industry with potential asbestos exposure, make sure your doctor knows about it. Mesothelioma is rare, but it occurs at a much higher rate in people with asbestos exposure. As a patient, one of the most important things you can do is to ask as many questions as you can about your condition. Open communication with your doctor can help ensure you receive an accurate diagnosis so you can begin appropriate treatment as soon as possible.

Common Questions About Mesothelioma Misdiagnosis

Why is mesothelioma so difficult to diagnose?

Mesothelioma is difficult to diagnose because its symptoms are nonspecific and resemble those of other more common conditions. This disease often presents with symptoms like chest pain, shortness of breath or stomach pain, which can easily be misdiagnosed as a less severe illness. This type of cancer is also incredibly rare, leading most doctors to misdiagnose it when a patient initially presents with symptoms. Further complicating matters, mesothelioma can develop decades after initial exposure to asbestos. A biopsy is required for diagnosis, making early and accurate detection difficult.

What diseases or conditions mimic mesothelioma?

Diseases that mimic mesothelioma include pneumonia, emphysema, the flu, gallstones, hernia, irritable bowel syndrome, ovarian cancer, abdominal pain, digestive issues, coronary artery disease, heart disease, lupus, tuberculosis and other forms of cancer.

How can a mesothelioma diagnosis be confirmed?

The only way to confirm a diagnosis of mesothelioma is to biopsy the suspected tissue and have a pathologist examine it. Doctors may also use imaging tests, such as X-rays, CT scans and MRI scans, to identify any abnormalities. Blood tests for biomarkers can also support a mesothelioma diagnosis, but the only way to confirm a mesothelioma diagnosis is through a biopsy.

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