What Is Desmoplastic Mesothelioma?
Desmoplastic malignant mesothelioma is a very uncommon and aggressive subtype of mesothelioma. It accounts for roughly 5-10% of mesothelioma cases, according to the medical organization Pathology Outlines.
Desmoplastic mesothelioma is a subtype of sarcomatoid mesothelioma, the most aggressive mesothelioma histological (cell) type.
Patients with desmoplastic mesothelioma histology have a shorter prognosis (health outlook) than those with other types of mesothelioma. However, many patients have extended their life expectancy with specialized treatment.
Key Facts on Desmoplastic Malignant Mesothelioma
- Develops in the lining of the lungs (pleura), abdomen (peritoneum), heart (pericardium), or testicles (tunica vaginalis).
- Metastasizes (spreads) more often than other cell types (biphasic and epithelial), making it harder to treat.
- Up to 60% of patients experience distant metastasis (where cancer reaches the ribs, skull, or sternum).
- The average life expectancy is 6 months or less, but treatments may allow some patients to live longer.
Mesothelioma Hope is here to help patients with any mesothelioma cell type better understand their diagnosis and find the treatments they need.
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What Is the Cause of Desmoplastic Mesothelioma?
Like all other types of this cancer, the only known cause of desmoplastic mesothelioma is asbestos exposure.
Asbestos is a very durable, fiber-like mineral used in many products between the 1930s and early 1980s to make them stronger and heat-resistant. Manufacturers of asbestos-based products hid the risks of this substance to make money.
Handling asbestos-containing products could release fibers into the air, and if you inhaled or swallowed them, you could develop mesothelioma 10-50 years later.
Desmoplastic mesothelioma forms when sarcomatoid mesothelioma cells develop dense connective tissue called stroma around themselves. Stroma helps the cancer build blood vessels that it uses to grow.
Symptoms of Desmoplastic Mesothelioma
Mesothelioma symptoms vary depending on where the cancer forms in the body. Learn about the most common warning signs of desmoplastic mesothelioma below.
Desmoplastic Pleural Mesothelioma Symptoms
Malignant pleural mesothelioma forms in the lung lining, so patients usually have chest-related symptoms.
Symptoms of desmoplastic pleural mesothelioma may include:
- A cough
- Chest pain
- Collapsed lung
- Fatigue
- Pleural effusion (fluid buildup in lung lining)
- Pleural thickening
- Shortness of breath (dyspnea)
More severe symptoms can develop as the cancer spreads. A patient with desmoplastic pleural mesothelioma suffered from paresis (muscle weakness and partial paralysis) in his leg after the cancer reached his spinal cord, according to a 2021 Clinical Lung Cancer report.
Desmoplastic Peritoneal Mesothelioma Symptoms
Peritoneal mesothelioma is the second most common type of this cancer and develops in the abdominal lining.
Common symptoms of desmoplastic peritoneal mesothelioma include:
- Abdominal pain
- Ascites or peritoneal effusion (fluid buildup in abdominal lining)
- Constipation/diarrhea
- Thickening of the abdominal lining
- Weight loss
Get our Free Mesothelioma Guide to learn about mesothelioma symptoms to watch for and how to ensure they’re properly diagnosed.
Getting a Desmoplastic Mesothelioma Diagnosis
Doctors typically must use several steps to make a diagnosis of desmoplastic malignant mesothelioma or any other form of this cancer.
These steps include:
- Conducting a basic health screening to assess a patient’s symptoms
- Taking imaging tests like X-rays and computed tomography (CT) scans to look in the body
- Performing a biopsy (removal of fluid/tissue sample to check for cancer cells)
Doctors can also use more tests to ensure the right diagnosis. A 2022 report published in Modern Pathology noted that doctors can use a technique called immunohistochemistry staining to detect proteins specific to desmoplastic mesothelioma, such as cytokeratin.
It’s critical to see a doctor if you think you may have mesothelioma — it could save your life. In 2022, Cureus noted that doctors removed an early-stage desmoplastic tumor from a 71-year-old woman after detecting it on imaging scans. She was still cancer-free a year later.
If pathologists see sarcomatoid tumor cells surrounded by dense fibers on a biopsy sample, they can confirm you have desmoplastic mesothelioma.
Misdiagnosing Desmoplastic Mesothelioma
Desmoplastic mesothelioma is challenging to correctly diagnose. Doctors may not find sarcomatoid spindle cells in a biopsy since tumors contain so much stroma, according to a study from the Annals of Thoracic Surgery. For this reason, desmoplastic mesothelioma is easily misdiagnosed.
Some of the most common differential diagnoses include:
- Encapsulating peritoneal sclerosis, a condition where peritoneal thickening surrounds the small intestine
- Fibrous pleuritis (pleurisy), which is inflammation of the lung lining
- Pleural plaque, a non-cancerous buildup of collagen in the lung lining
- Other cancers like carcinoma or sarcoma cells
Patients who believe they’ve been misdiagnosed should seek a second opinion from a specialist who’s familiar with mesothelioma.
Get matched with top mesothelioma specialists near you using our Free Doctor Match service.
Desmoplastic Mesothelioma Prognosis
Desmoplastic mesothelioma generally has a less than favorable prognosis, with many patients living only a few months after diagnosis.
The sarcomatoid cells of desmoplastic tumors spread faster than epithelioid mesothelioma cells do, making this particular cancer harder to treat. However, you may be able to live longer with the right medical care.
Desmoplastic Mesothelioma Life Expectancy
The overall life expectancy of desmoplastic mesothelioma patients is under 6 months, according to a report published in The American Journal of Clinical Pathology.
However, the same report noted that a desmoplastic mesothelioma patient was still alive 1.5 years later after major surgery. This proves that even with a challenging prognosis, there is hope for a longer and fulfilling life.
Desmoplastic Mesothelioma Survival Rates
Mesothelioma survival rates indicate the percentage of patients still alive after a set period of time.
Specific desmoplastic mesothelioma survival rates haven’t been reported, but the 2-year survival rate for general sarcomatoid mesothelioma is 15% when treated with surgery.
While this survival rate is low, it still may be possible for you or a loved one to live much longer based on your treatment plan, overall health, and other factors.
Get our Free Mesothelioma Guide to explore treatment options that could help you live longer after a diagnosis.
Desmoplastic Mesothelioma Treatment
Doctors can use several different mesothelioma treatments to improve the survival times for desmoplastic patients. Learn more about each treatment method below.
Surgery
Surgery allows doctors to remove desmoplastic mesothelioma tumors from the body.
The three main surgeries for desmoplastic mesothelioma are:
- Cytoreduction with HIPEC: Used to treat peritoneal mesothelioma by combining abdominal surgery and heated chemotherapy
- Extrapleural pneumonectomy (EPP): Used to treat pleural mesothelioma by removing the lung closest to the cancer, the lung lining (pleura), and tumors from the lung and chest wall
- Pleurectomy with decortication (P/D): Also treats pleural mesothelioma by extracting the lung lining and tumors while leaving both lungs in tact
A case study in The American Journal of Clinical Pathology reported on a woman with desmoplastic mesothelioma who was still alive 1.5 years after P/D surgery. This is 3 times longer than the average life expectancy for desmoplastic mesothelioma.
Chemotherapy
Chemotherapy involves administering medications that circulate through the body and destroy cancerous mesothelial cells. It can be used as the primary treatment for desmoplastic mesothelioma or combined with other treatments like surgery.
A patient with stage 4 desmoplastic mesothelioma received chemotherapy and lived for nearly a year before passing away from other causes, as noted in a report in BMC Cancer.
Radiation
Radiation therapy uses beams of energy that are targeted at specific areas in the body. It’s typically used as part of a larger treatment plan to help those with desmoplastic mesothelioma.
Doctors administered radiation to ease a patient’s double vision, which developed after desmoplastic mesothelioma tumors spread to his skull, in a report from The American Journal of Respiratory and Critical Care Medicine. The patient was then encouraged to see cancer surgeons and explore palliative care to manage his symptoms.
Immunotherapy
Immunotherapy boosts the body’s immune response so it can more effectively kill cancer cells.
The U.S. Food and Drug Administration (FDA) has approved two immunotherapy drugs, nivolumab (Opdivo®) and ipilimumab (Yervoy®), as a mainstream pleural mesothelioma treatment.
A 2022 study published in Oncology Letters noted that Opdivo® alone helped partially slow the growth of desmoplastic mesothelioma in two patients.
Get a Free Mesothelioma Guide shipped overnight to find out more about different treatments that can help you or a loved one live longer with this cancer.
New and Emerging Treatments
Desmoplastic mesothelioma patients may also have the option to access new treatments being tested in clinical trials.
Many clinical trials are recruiting sarcomatoid mesothelioma patients. Since desmoplastic mesothelioma is a sarcomatoid subtype, you or a loved one may be able to join these trials.
One ongoing trial is Alliance A08210, in which doctors use immunotherapy to shrink sarcomatoid mesothelioma tumors and then remove them with surgery.
“Giving immunotherapy before surgery may be more effective at controlling disease in patients with sarcomatoid mesothelioma than giving immunotherapy alone.”
–Alliance A082101 study authors
A mesothelioma doctor can determine if you’re eligible to join a clinical trial.
Find Help for a Desmoplastic Mesothelioma Diagnosis
While desmoplastic mesothelioma is aggressive, it’s important to stay hopeful after a diagnosis. This cancer is not an automatic death sentence, and you can take action to potentially live longer.
The Mesothelioma Hope team is here to help you navigate life with desmoplastic mesothelioma. Our registered nurses and Patient Advocates can walk you through your options, allowing you to make more informed decisions about your medical care.
We can help you:
- Better understand your diagnosis
- Find doctors and cancer centers in your area
- Get supportive care for mesothelioma
- Pursue financial compensation to pay for your treatment
Take the first step toward healing by calling (866) 608-8933 or using our Free Doctor Match to get the guidance you need.
Desmoplastic Malignant Mesothelioma FAQs
What is the rarest mesothelioma type?
Desmoplastic mesothelioma is one of the rarest types of mesothelioma, making up just 5-10% of all cases, according to Pathology Outlines.
It is a subtype of sarcomatoid mesothelioma, which is the least common mesothelioma cell type.
Even though desmoplastic mesothelioma is a rare cancer, there are several doctors across the country who can recommend treatments that can improve your prognosis and quality of life.
What is the life expectancy of a person with desmoplastic mesothelioma?
The current life expectancy for desmoplastic mesothelioma patients is 6 months or less. This cell subtype is very aggressive and can easily spread to other parts of the body, which is why the median survival is poor.
However, you could live longer depending on which treatments you receive, your cancer stage, overall health, and other factors.
Is desmoplastic mesothelioma curable?
There’s no known cure for desmoplastic mesothelioma yet. However, treatment options like surgery, chemotherapy, and immunotherapy can help you or a loved one live longer with fewer symptoms.
Get our Free Mesothelioma Guide to learn about the different treatments that could work for you.