Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 15-12: Mesothelioma + Key Features Download Section PDF Listen +++ ++ Rare malignancy of peritoneum, pleura History of asbestos exposure in > 70% + Clinical Findings Download Section PDF Listen +++ ++ Abdominal pain or bowel obstruction Increased abdominal girth, with small to moderate ascites + Diagnosis Download Section PDF Listen +++ ++ Chest radiograph shows pulmonary asbestosis in > 50% Ascitic fluid is hemorrhagic, with low serum-ascites albumin gradient Ascitic fluid cytology is often negative Abdominal CT or positron emission tomography-CT reveals sheet-like masses involving the mesentery and omentum Diagnosis at laparotomy or laparoscopy + Treatment Download Section PDF Listen +++ ++ Prognosis is extremely poor However, some patients survive long-term after a combination of surgical debulking and intraoperative intraperitoneal chemotherapy, followed by early postoperative intraperitoneal chemotherapy Postoperative radiotherapy or combination chemotherapy may be helpful Multicystic and well-differentiated papillary mesotheliomas are associated with a long survival with surgical treatment alone