RT Book, Section A1 Raja, Siva A1 Farver, Carol F. A1 Murthy, Sudish C. A1 Mason, David A2 Yuh, David D. A2 Vricella, Luca A. A2 Yang, Stephen C. A2 Doty, John R. SR Print(0) ID 1104587736 T1 Benign and Malignant Pleural Tumors T2 Johns Hopkins Textbook of Cardiothoracic Surgery YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 978-0-07-166350-2 LK accesssurgery.mhmedical.com/content.aspx?aid=1104587736 RD 2024/03/28 AB EpidemiologyPleural tumors are a small but significant subset of thoracic malignancies. The majority of pleural tumors tend to be malignant and mesothelioma is the most common diagnosis. Most patients have had environmental exposure to asbestos.PathophysiologyPleural tumors are generally characterized as benign or malignant. Benign tumors are usually slow growing and do not cause symptoms until they exert mass effect, or in the case of MPM, when they cause pain by tumor invasion or dyspnea secondary to pleural effusion.Diagnosis/clinical featuresMany pleural-based tumors are diagnosed incidentally on imaging performed for unrelated reasons. The primary radiographic evaluation consists of CXR and CT scan. Once the pleural-based lesions have been identified, tissue diagnosis is obtained via image-guided core-needle biopsy or through thoracoscopic biopsy. When symptoms are present, they are most commonly chest wall pain from tumor invasion or dyspnea from restriction or cough.TreatmentBenign tumors of the pleura are followed with serial imaging or resected. Treatment options for MPM are varied and range from palliation of symptoms to radical surgery within a multimodality regimen.PrognosisThe prognosis for benign lesions of the pleura is excellent and recurrences are rare after complete resection. MPM, however, is often advanced at presentation and prognosis is poor. However, early-stage patients with epithelioid histology and negative resection margins have promising long-term survival.