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Benign Mesothelioma

Benign mesothelioma is a rare, non-cancerous form of mesothelioma comprised of four subtypes that affect both men and women.

Unlike other forms of the disease, there is no direct link between benign mesothelioma and asbestos exposure, though other risk factors have emerged. There have been limited documented cases of each subtype, with fewer than 200 cases of benign multicystic peritoneal mesothelioma (BMPM), fewer than 60 diagnosed cases of well-differentiated papillary mesothelioma (WDPM) and fewer than 25 reported cases of benign adenomatoid tumors (AT) and local fibrous tumors (LFT). Growth and prognosis vary based on subtype, but prognosis is generally favorable for benign mesothelioma patients, with curative surgery as the main treatment option.

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Benign Cell Structure

The cell structure of benign mesothelioma tumors differs based on type. However, most subtypes are composed of epithelial cells. Epithelioid cells are noted for growing in clusters, and are much slower to metastasize compared to other cell types. Epithelial cells are also the most responsive to treatment and offer a better prognosis.

A defining characteristic between benign mesothelioma and malignant mesothelioma is how the disease progresses. Malignant mesothelial cells invade tissues and can spread to other areas of the body, affecting organs and lymph nodes, and limiting treatment options. Benign mesothelioma cells do not invade or spread, allowing for complete surgical resection.

Rare Benign Cell Types

Benign mesothelioma is rarer than the malignant form, leading to a limited number of cases. Based on the cases that have accumulated, four rare subtypes have been established. While most cases are benign, some of these subtypes can also manifest as malignant cells.

Diagnosing Benign Mesothelioma

Every case of benign mesothelioma manifests differently, and a patient’s overall health and age can affect the presence or severity of symptoms. With a limited number of cases, it’s difficult to pinpoint common symptoms of benign mesothelioma, and many patients experience no symptoms. In some instances, they may mimic symptoms of malignant mesothelioma, like chest pain, abdominal pain, weight loss, chronic cough and pleural effusion. Any potential symptoms should be addressed immediately.

If mesothelioma is suspected, a doctor will look at the patient’s history and symptoms, and will also conduct a variety of tests to determine the presence of mesothelioma, if it is malignant or benign, and mesothelioma type.

Diagnostic testing will include imaging tests like CT scans, X-rays and MRI scans, followed by biopsies to definitively classify the disease as benign or malignant. Doctors use a biopsy to analyze tumor cells under a microscope and identify cell size and shape, nucleus size and shape and cell arrangement. These characteristics show whether a cell is benign or cancerous and will also allow the physician to determine cancer type and whether or not the cancer has spread.

Malignant Mesothelioma Benign Mesothelioma
Common treatment: Multimodal approach of surgery, chemotherapy and/or radiation Common treatment: Curative surgery
Metastasis: Aggressive Metastasis: None, but potential for local recurrence
Organ and tissue damage: Damage to nearby tissues and organs with potential for distant damage Organ and tissue damage: Typically none

Determining malignancy will be a driving factor in a patient’s treatment plan and prognosis. Early detection of malignant mesothelioma is important to giving patients the best treatment options possible, and if benign, curative surgery has shown high success rates in treating patients, offering a full recovery without need for additional treatment.

Benign Mesothelioma Prognosis

Life expectancy is generally unaffected by a benign mesothelioma diagnosis, and most patients are able to live a full life after the tumor is removed. However, recurrence is possible, especially for benign multicystic peritoneal mesothelioma. Tumors can return as malignant, which would then present patients with a very poor prognosis depending on the stage of cancer and location. On average, malignant mesothelioma patients survive 12 to 21 months.

Survival rates vary widely depending on the subtype of mesothelioma, and if patients face a malignant recurrence.

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