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Call Now (855) 404-4592Papillary mesothelioma is a rare subtype of epithelial mesothelioma. Tumors form in the lining of the abdomen (peritoneum) and the lining of the lungs (pleura).
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The majority of well-differentiated papillary mesothelioma (WDPM) tumors develop in women, specifically in the abdominal cavity. Less commonly, doctors have found WDPM tumor growth on several of the body’s protective membranes, including the pleura (lining of the lungs), pericardium (heart sac) and tunica vaginalis (lining of the testes).
From a medical standpoint, these tumors are practically benign. Studies have reported WDPM turning into malignant mesothelioma over time, although the chance of this happening is unlikely. Some people with WDPM have also experienced multiple recurrences after treatment.
A February 2019 study published in the Annals of Diagnostic Pathology observed 75 cases of WDPM diagnosed between 2000 and 2017 at Fudan University Shanghai Cancer Center in China.
Patients in the study included 58 females and 17 males ranging in age from 18 to 69 years. Of the 75 cases, only one turned cancerous.
A 2021 research report in Modern Pathology stated that solid papillary mesothelioma tumors appear to be either benign or very low-grade tumors that need to be separated from malignant mesotheliomas.
At this point, researchers are unsure whether papillary mesothelioma is linked to asbestos exposure. Some patients have a history of asbestos exposure, but most do not. The cause of this disease remains poorly understood.
According to a 2019 study published in Annals of Surgical Oncology, approximately 50 cases of WDPM in the peritoneum have been described in medical literature. There are also several small case reports of WDPM of the pleura. Another study indicated that there are fewer than 20 documented cases of testicular papillary mesothelioma.
Many cases of well-differentiated papillary mesothelioma have no symptoms, but the disease has been known to cause pain and excessive fluid buildup in the pleura or abdomen of some patients.
WDPM of the tunica vaginalis can cause scrotal swelling or the formation of testicular lumps. In one study of 22 WDPM cases, only two patients reported to their doctors with symptoms. One patient experienced acute abdominal pain, and the other had chronic pelvic pain.
Because well-differentiated papillary mesothelioma rarely causes symptoms, doctors usually discover tumor growth during an unrelated pelvic or abdominal surgery. WDPM can sometimes be found with an imaging test, such as a CT scan, but this technique isn’t sensitive enough to detect tumors smaller than 1 centimeter in size.
The only definitive procedure for diagnosing WDPM and other mesotheliomas is a biopsy — the collection of a tissue sample for laboratory analysis.
It is important for doctors to collect a comprehensive sample to prevent misdiagnosis, because highly aggressive malignant mesothelioma tumors sometimes feature areas of papillary cell growth.
With only a limited amount of research on the management of well-differentiated papillary mesothelioma, doctors have yet to reach a consensus on the most effective course of treatment.
Therapy usually involves a combination of the main types of mesothelioma treatment, including surgery, chemotherapy and radiation therapy.
Treatment options also depend on where the papillary mesothelioma tumors form.
For example, WDPM on the peritoneum may be treated with a combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, also known as HIPEC. In the 2019 study published in Annals of Surgical Oncology, 37 of the 56 patients were treated with this combination.
The survival outlook for patients with well-differentiated papillary mesothelioma is significantly better than the prognosis of patients with most other mesothelioma cell types.
While only 5% to 10% of malignant mesothelioma patients survive five years after diagnosis, several patients with WDPM have survived for decades.
| WDPM of the Pleura | WDPM of the Peritoneum |
|---|---|
| 6 years and 2 months | 12 years |
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