Wednesday, December 22, 2010

Malignant Mesothelioma in Singapore

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mesothelioma has become a very big issue the world over,with the major cause identified as asbestos inhalation or contact with body organ.
In singapore malignant mesothelioma was experience in the general hospital.
Below is the abstract from the annals academy of medicine in singapore:
Annals Academy of Medicine
Malignant Mesothelioma—K Chan et al
Malignant Mesothelioma: Experience at the Singapore General Hospital
K Chan,*MBBS, MRCP (UK), M Med (Int Med), K L Tan,**FAMS, MRCP (UK), FCCP, H S Lee,***FAMS, MBBS, M Med (Occup Med),
P Eng,****FAMS, MBBS, M Med (Int Med)
Abstract
Introduction: Malignant mesothelioma is a rare occupational disease in Singapore. There have been few reports of this condition in
Singapore. We aim to describe the clinical characteristics, management and outcomes in a case series of 16 patients diagnosed in a teaching
hospital in Singapore. Materials and Methods: A chart review of all cases of malignant mesothelioma diagnosed in our institution during
the period 1996 to 2001 was conducted, with particular attention to the occupational history. Results: There were 16 patients (15 male
patients) with a median age of 61.5 (range, 46 to 78) years. Thirteen patients had malignant pleural mesothelioma (MPM) and 3 patients
had mesothelioma of the peritoneum. Eleven of the patients with MPM (84.6%) presented with a pleural effusion and only 2 patients (15.4%)
had chest pain. Initial pleural fluid cytology and closed pleural biopsies were negative in all patients who presented with a pleural effusion.
Thoracoscopy confirmed the histologic diagnosis and allowed simultaneous talc pleurodesis in 9 patients. All patients had documented asbestos
exposure, of which 14 (87.5%) were confirmed to be occupationally related. The median time from first exposure to symptoms was 33.5 (range,
16 to 53) years. The median survival was 6 months. Most of the patients (75%) received best supportive care alone. Conclusions: In our experience,
malignant mesothelioma is an aggressive disease with a poor prognosis. It is strongly associated with asbestos exposure. Thoracoscopy is an
invaluable diagnostic modality in the evaluation of a patient with occupational asbestos exposure and an undiagnosed pleural effusion.
Ann Acad Med Singapore 2003; 32:388-91