Childhood Mesothelioma

Malignant mesothelioma of the pleuraMesothelioma is a rare form of aggressive cancer that affects the membrane lining of the lungs and abdomen. It is usually caused by exposure to asbestos.

It is usually the cancer of old age due to its long latency period. The average age at the time of diagnosis has been found to be sixty-five years.

Although, it is extremely rare in children but certain studies showed the presence of mesothelioma in children. Only nine cases of the childhood mesothelioma (pediatric mesothelioma) were found in U.S. between 1999 and 2002. Seven cases of malignant mesothelioma were reported in Memorial Hospital from 1953 to 2006. Among those cases, five patients died within two years of the diagnosis while the two patients lived more than five years.

History:

A research published in 1980, studied eighty children in which ten children had mesothelioma cancer. Researchers found that only four had been thought to be exposed to asbestos. Six of them were boys. Pleural mesothelioma was diagnosed in eight children. Two children lived until the age of nineteen.

In another research, the cases and death certificates of 42,597 children who had died of cancer in the U.S. during the 1960s were examined and reviewed. 31 cases of death were reported as a result of mesothelioma disease while less than half of those cases could be confirmed by hospital records. Researchers found no history of asbestos exposure in 13 confirmed cases.

Causes:

Researchers are of the opinion that medications before birth, radiation exposure and genetic factors could be the causes of childhood mesothelioma. Moreover, environmental factors such as asbestos exposure could play an important role in the development of childhood mesothelioma. However, among the seven cases in Memorial Hospital, none of the children was found to have an asbestos exposure in the lifetime.

Diagnosis:

The symptoms of mesothelioma are same in children as those in adults. Among the primary symptoms are pleural effusions (excess fluid in the lungs), loss of appetite, abdominal pain and weight loss.

Researchers reported that among the seven cases of childhood mesothelioma (in Memorial Hospital), six children had pleural mesothelioma and one had peritoneal mesothelioma.

Treatment:

Unfortunately, there is no standard therapeutic strategy for the mesothelioma treatment in children. Usually adults are treated with chemotherapy, radiation therapy or surgery but children face a very poor prognosis.

Researchers reported that among the seven patients of childhood mesothelioma in Memorial hospital, surgery or radiotherapy were not effective in most of the patients. However, one patient showed complete response to a combination of Adriamycin, cyclophosphamide, and vincristine and has remained free of disease for five and a half years.

In another study, researchers presented four pediatric cases of mesothelioma, who were treated with a cisplatin-based doublet regimen. They found that the treatment was well tolerated and three of the patients achieved long-term survival.

Further Reading:

http://www.mesothelioma.com/mesothelioma/information/children-with-mesothelioma.htm accessed February 17, 2013

http://www.asbestos.com/mesothelioma/children-young-adults.php accessed February 17, 2013

Cooper SP, Fraire AE, Buffler PA, Greenberg SD, & Langston C (1989). Epidemiologic aspects of childhood mesothelioma.Pathology and immunopathology research, 8 (5-6), 276-86 PMID: 2699035

Leigh-Anne Cioffredi BA, Pasi A. Jänne MD, PhD, David M. Jackman MD, (2009). Treatment of peritoneal mesothelioma in pediatric patients. Pediatric Blood & Cancer, doi: 10.1002/pbc.21718

Joseph Brenner MD, Dr. Peter P. Sordillo MD, Gordon B. Magill MD, (2006). Malignant mesothelioma in children: Report of seven cases and review of the literature. Medical and Pediatric Oncology, doi: 10.1002/mpo.2950090409

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