Desmoplastic Malignant Mesothelioma; DMM

Desmoplastic Mesothelioma is a rare and highly aggressive cancer that most commonly occurs in the pleura, the membranous enclosures surrounding the lungs. It occasionally originates in the linings of the heart (pericardium) and visceral organs (peritoneum). The term “desmoplastic” refers to the signature masses of fibrous connective tissue produced in affected areas.

Unlike other subtypes of mesothelioma, the desmoplastic variant is not as closely linked to asbestos; less than 20% of cases involve confirmed asbestos exposure. Desmoplastic mesothelioma affects males twice as frequently as females, and usually presents after age 40, though it has been observed in patients as young as 12 years of age.

Diagnostic testing: Desmoplastic mesothelioma is frequently mistaken for pleural fibrosis upon examination. Biopsy analysis is required to confirm the diagnosis.

Physical findings: Common symptoms include:

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  Shortness of breath;

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  Pain in the chest or abdomen;

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  Lumps or swelling at cancer site; and

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  Sudden weight loss.

ICD-9: 163 (pleural); 158 (peritoneal); 164.1 (pericardial)

ICD-10: C45.0 (pleural); C45.1 (peritoneal); C45.2 (pericardial)

Desmoplastic mesothelioma has usually metastasized by the time it is discovered. The prognosis is extremely poor, with a median survival rate of about six months following diagnosis.

Because desmoplastic mesothelioma tends to be in an advanced stage at the time of diagnosis, surgery is rarely an option. Treatment is palliative and supportive, and includes chemotherapy and targeted radiation to shrink tumors. Draining fluid buildup can increase comfort and ease of breathing.

Suggested MER for Evaluation:

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  Clinical history and examination that describes the diagnostic features of the impairment;

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  Imaging reports such as CT scan or MRI scan;

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  Operative reports; and

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  Pathology/biopsy reports.

Suggested Listings for Evaluation:

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