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Papillary Mesothelioma
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Papillary mesothelioma, also called well-differentiated papillary mesothelioma, is a rare subtype of epithelial mesothelioma. Well-differentiated papillary mesothelioma affects the lining of the abdomen (peritoneum), the lining of the lungs (pleura) and the lining of the testes (tunica vaginalis).
Written by Karen Selby, RN | Medically Reviewed By Dr. Rupesh Kotecha | Edited By Walter Pacheco | Last Update: June 27, 2024
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Written by Karen Selby, RN | Medically Reviewed By Dr. Rupesh Kotecha | Edited By Walter Pacheco | Last Update: June 27, 2024
Where Does Papillary Mesothelioma Develop?
The majority of well-differentiated papillary mesothelioma (WDPM) tumors develop in women and grow in the abdominal cavity.
Doctors have found WDPMT tumor growth on several of the body’s protective membranes, including the pleura (lining of the lungs), pericardium (heart sac) and tunica vaginalis (lining of the testes).
Is WDPMT Cancerous?
From a medical standpoint, these tumors are benign. Some cases have turned into malignant mesothelioma over time, but the chance of this happening is unlikely. Some people with WDPMT have also experienced several recurrences after treatment.
Well-differentiated papillary mesothelioma.
Solid papillary mesothelioma tumors are benign or very low-grade tumors. Differentiating from malignant mesotheliomas is essential. A 2021 research report in Modern Pathology reported this stance.
Is There an Asbestos Connection?
Researchers are unsure if asbestos exposure causes this tumor. Some patients have a history of asbestos exposure, but most do not. The cause of this disease remains.
About 50 cases of WDPMT in the peritoneum exist in the medical literature. A 2019 study published in Annals of Surgical Oncology reported this data. There are also several small case reports of WDPM of the pleura. About 20 documented cases of testicular papillary mesothelioma exist.
Symptoms and Characteristics
Many cases of well-differentiated papillary mesothelioma tumors have no symptoms. The disease causes pain and excessive fluid buildup in some patients.
Primary Characteristics of WDPMT
- Well-differentiated tumors are low grade. This means their cancer cells resemble healthy cells and grow and multiply at a slow rate.
- The cancer does not invade nearby tissues or spread throughout the body.
- WDPMT is completely inactive in some cases, showing no signs of cell division.
- The tumor’s cells feature small, finger-like projections called papillae.
- Papillae sometimes create round swirls of calcium known as psammoma bodies.
- Tumors form white or grey nodules ranging from less than 1 centimeter in size to more than 3 centimeters.
- WDPMT can develop as a solitary mass or arise in many sites. The latter has more aggressive behavior.
- Tumors are smaller than 1 centimeter in more than half of all cases.
WDPMT of the tunica vaginalis can cause scrotal swelling or the formation of testicular lumps. In one study of 22 WDPMT cases, only two patients reported symptoms to their doctors. One patient experienced acute abdominal pain, and the other had chronic pelvic pain.
Misdiagnosis and Challenges
Doctors must collect a comprehensive tumor sample to prevent misdiagnosis. The only definitive procedure for diagnosing WDPM and other mesotheliomas is a biopsy, which collects a tissue sample for laboratory analysis.
Doctors may confuse WDPMT with several other cancers and conditions:
- Reactive mesothelial hyperplasia
- Adenomatoid tumor
- Peritoneal carcinomatosis
- Tuberculous peritonitis
- Serous papillary carcinoma of the ovary
- Serous papillary carcinoma of the peritoneum
While looking for signs of mesothelioma, doctors also look for negative markers. These markers signal that the tumor is likely not mesothelioma but another type of cancer. For example, mesothelioma patients rarely test positive for the PAX8 protein. If it’s detected, this could signal kidney cancer, thyroid cancer and cancers of the female reproductive system.
Doctors usually discover this condition during an unrelated pelvic or abdominal surgery. An imaging test, such as a CT scan, may find it. However, this technique isn’t sensitive enough to detect tumors smaller than 1 centimeter.
Papillary Mesothelioma Treatment
Doctors have yet to reach a consensus on the most effective course of treatment.
Therapy usually involves a combination of the main types of mesothelioma treatment. These include surgery, chemotherapy and radiation therapy. Treatment options also depend on where the papillary mesothelioma tumors form.
A combination of surgery and heated chemotherapy treats abdominal cases. In a 2019 Annals of Surgical Oncology study, 37 of the 56 patients received this combination.
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Get Your Free GuidePrognosis and Survival Rate of Papillary Mesothelioma
The outlook is better than the prognosis of patients with most other mesothelioma cell types.
Median Survival for Well-Differentiated Papillary Mesothelioma Tumor
| WDPMT of the Pleura | WDPMT of the Peritoneum |
|---|---|
| 6 years and 2 months | 12 years |
Source:
American Journal of Surgical Pathology, 2004; Annals of Surgical Oncology, January 2019
Only 5% to 10% of malignant mesothelioma patients survive five years after diagnosis. Several patients with WDPMT have survived for decades.
This Page Contains 6 Cited Articles
The sources on all content featured in The Mesothelioma Center at Asbestos.com include medical and scientific studies, peer-reviewed studies and other research documents from reputable organizations.
- Churg, A. et al. (2021, September 3). Solid papillary mesothelial tumor. Retrieved from https://www.nature.com/articles/s41379-021-00899-3
- Sun, M. et al. (2019, February). Well-differentiated papillary mesothelioma: A 17-year single institution experience with a series of 75 cases. Retrieved from https://www.sciencedirect.com/science/article/pii/S1092913418303204?via%3Dihub
- Vogin, G. et al. (2019, January 11). Well-Differentiated Papillary Mesothelioma of the Peritoneum: A Retrospective Study from the RENAPE Observational Registry. Retrieved from https://link.springer.com/article/10.1245%2Fs10434-018-07153-2
- Erdogan, S. et al. (2014, June). Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: A Case Study and Review of the Literature. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087136/
- Malpica, A. et al. (2012). Well-differentiated Papillary Mesothelioma of the Female Peritoneum: A Clinicopathologic Study of 26 Cases. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22024662
- Galateau-Salle, F. et al. (2004). Well-differentiated Papillary Mesothelioma of the Pleura: A Series of 24 Cases. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15087673
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