Introduction Can be malignant or benign Malignant mesothelioma can be localized or diffuse Risk factors include: asbestos exposure talc Benign usually involves visceral pleura, and appears as pedunculated "broccoli" lesion on a stalk coming of the lung Presentation Localized: pleuritic pain, joint pain, swelling, dyspnea Diffuse: chest pain, malaise, weight loss, cough Evaluation CXR CT Pleural effusion present in 10% with local disease, >75% with diffuse disease Diagnosis made with pleural biopsy shows "dumbell bodies" Treatment Localized malignant: surgical excision Diffuse malignant: early stages may be resected, otherwise radiation and/or chemo Benign: surgical resection with 1cm margin Prognosis and Complications Localized malignant: poor if tumor is malignant Diffuse malignant: dismal (average life span after diagnosis is one year) Benign: excellent with cure in vast majority of cases