Pleural carcinomatosis - specialists and information

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Doctors define pleural carcinomatosis as the presence of cancer metastases in the pleura. It is not uncommon for the spreading primary tumor to be in the immediate vicinity, e.g. lung cancer or breast cancer. One of the main symptoms of pleural carcinomatosis is breathing problems, including shortness of breath (dyspnoea).

Find out more about symptoms, treatment and specialists in this article.

ICD codes for this diseases: C38.4

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Article overview

What is pleural carcinomatosis?

Pleural tumors (pleural tumors) are tumors of the pleura. This consists of the pleural sheets, the pleura and the pleura of the lungs. It protects the lungs and enables breathing.

PleurakarzinoseIn pleural carcinomatosis, the pleura is affected by metastases as part of a cancer @ stockdevil /AdobeStock

Causes and types of pleural carcinomatosis

Primary pleural tumors develop directly in the pleura and are extremely rare. Around three percent of all pleural tumors are primary, with 80 percent originating from the pleura and 20 percent from the pleura. These tumors are often associated with asbestos exposure.

Secondary pleural tumors, on the other hand, develop as a result of the spread of cancer cells (metastasis) from other cancers. In particular lung cancer or breast cancer. Experts also refer to these secondary pleural tumors as pleural carcinomas. They account for around 97 percent of all pleural tumors.

Symptoms of pleural carcinomatosis

Pleural tumors often remain "silent", meaning that more than half of those affected show no symptoms.

If symptoms do occur, they are as follows:

  • Chest pain
  • Shortness of breath
  • Chronic cough
  • Cancer symptoms in the advanced stage include
  • Fatigue
  • States of exhaustion
  • Reduced performance
  • Loss of appetite
  • Unintentional weight loss

A common complication of pleural carcinomatosis is pleural effusion, which makes breathing even more difficult and can cause severe shortness of breath. Malignant pleural effusion indicates advanced tumor disease or pleural carcinomatosis.

Diagnosis of pleural carcinomatosis

Diagnosis is based on clinical examinations and various imaging procedures such as

A tissue sample (biopsy) is ultimately crucial in order to differentiate between benign and malignant tumors of the pleura. However, it is also used to better characterize malignant pleural carcinomas before starting treatment. Such a tissue sample is taken as part of a thoracoscopy.

As classic pleural carcinomas are usually metastases of other tumors, doctors must first find and examine the primary tumor. Primary tumors are most frequently found in the breast, lungs or skin.

Treatment of pleural carcinomatosis

The treatment of pleural tumors requires interdisciplinary cooperation between different specialist groups:

They all work together as pleural cancer specialists to create individual treatment plans for the patient. Doctors usually have to remove pleural carcinomas surgically. Regular follow-up care is then important in order to detect relapses (recurrences) at an early stage.

Partial or total pleurectomy is available for the operation. This means that doctors remove part or all of the pleura. The partial or complete removal of the pleura ultimately improves the patient's shortness of breath (dyspnoea).

Prognosis for pleural carcinomatosis

The prognosis for pleural tumors varies greatly, as it depends on the nature of the tumor and the underlying disease.

If a malignant pleural effusion already exists, only palliative therapies are usually used. A cure is no longer possible due to the advanced stage of the disease.

One measure in such cases is, for example, drainage of the pleural effusion. This allows the fluid to drain away and makes it easier for the patient to breathe.

Preventing pleural carcinomatosis

Pleural carcinomatosis cannot be prevented with specific measures. Nevertheless, avoiding risk factors such as smoking is important in order to reduce the risk of cancer in general.

Early detection of pleural carcinomatosis is achieved by paying attention to persistent coughing or chest pain. In these cases, you should consult a doctor.

Conclusion

Pleural carcinomatosis is a complex disease that needs to be diagnosed carefully and as early as possible. Depending on the stage of the disease, individually tailored therapy or palliative medical care is necessary.

References

https://flexikon.doccheck.com/de/Pleurakarzinose
Ried M & Hofmann H-S. Behandlungskonzepte der Pleurakarzinose mit malignem Pleuraerguss. Dtsch Arztebl Int 2013; 110(18): 313-318 [Link: https://www.aerzteblatt.de/archiv/137724/Behandlungskonzepte-der-Pleurakarzinose-mit-malignem-Pleuraerguss]
https://www.springermedizin.de/emedpedia/thoraxchirurgie/tumoren-der-pleura?epediaDoi=10.1007%2F978-3-662-59159-8_51
https://www.usz.ch/krankheit/pleuratumoren/
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