What Is Sarcomatoid Mesothelioma?
Sarcomatoid mesothelioma is a rare cancer that starts in the lining of the lungs and other organs and is classified by mesothelioma tumors that contain sarcomatoid cells.
Sarcomatoid cells are shaped like spindles that look like long cylinders.
Key Facts on Sarcomatoid Mesothelioma
- Instead of growing in place, sarcomatoid mesothelioma cells move easily and quickly, which means metastasis (cancer spread) is common.
- The American Cancer Society (ACS) estimates that 10% to 20% of mesothelioma patients have the malignant mesothelioma sarcomatoid type.
- Even though it’s the most resistant to treatment, it’s also the least common of the three mesothelioma cell types (the others being epithelioid and biphasic).
Facing a sarcomatoid mesothelioma diagnosis? Our Patient Advocates have relationships with top mesothelioma doctors across the country who can provide the best treatment. Read all the details in our Free Mesothelioma Guide, shipped directly to you overnight.
What Causes Sarcomatoid Mesothelioma?
Exposure to asbestos is the only known cause of sarcomatoid mesothelioma.
Asbestos was used in various industries up to the early 1980s because of its heat-resistant and insulating properties. Unfortunately, the tiny fibers released when asbestos-containing products are damaged or disturbed carry severe health risks to workers and their families when breathed in or swallowed.
Asbestos fibers can become lodged in the lining of major organs (the mesothelium) and cause healthy cells to mutate into mesothelioma cancer.
Sarcomatoid Mesothelioma Symptoms
If you have sarcomatoid malignant mesothelioma, the signs and symptoms can differ depending on where the cancer shows up in your body (near the lungs or abdomen).
Recognizing the symptoms of sarcomatoid mesothelioma is crucial for getting a timely and accurate diagnosis. Learn more about the symptoms of each type of mesothelioma below.
Symptoms of Pleural Sarcomatoid Mesothelioma
Pleural sarcomatoid mesothelioma develops in the lung lining (pleura). About 20% of patients with pleural mesothelioma have the sarcomatoid cell type, according to a report in Respiratory Research.
Common symptoms include:
- Chest pain
- Fatigue
- Fluid buildup in the chest (pleural effusion)
- Shortness of breath
- Worsening cough
Symptoms of Peritoneal Sarcomatoid Mesothelioma
Peritoneal mesothelioma with sarcomatoid cells is a cancer that affects the abdominal lining (peritoneum). It’s quite rare, with only 32 cases reported in medical literature since 2006.
Common symptoms include:
- Abdominal pain
- Constipation or diarrhea
- Fluid buildup in the abdomen (peritoneal effusion)
- Night sweats
- Unexplainable weight loss
Learn more about what signs and symptoms to watch for and how to get an accurate diagnosis in our Free Mesothelioma Guide.
Getting a Sarcomatoid Mesothelioma Diagnosis
Most patients begin the diagnosis process when they go to the doctor for shortness of breath, chest or stomach pain, or other symptoms.
From there, the doctor will perform a physical exam and order a series of tests and imaging scans to help them rule out other conditions.
Procedures that may be used to help diagnose sarcomatoid malignant mesothelioma include:
- Blood tests for biomarkers (indicators of mesothelioma cancer)
- Chest X-rays
- Computed tomography scans (CT scans)
- Echocardiograms
- Magnetic resonance imaging (MRI) scans
- Positron emission tomography (PET) scans
If mesothelioma is suspected, doctors will take a sample of tissue or fluid and send it to a lab, where a pathologist will analyze it under a microscope to see what mesothelioma cells (if any) are present. This is what’s known as a biopsy.
A biopsy is the only test that can confirm sarcomatoid malignant mesothelioma since it allows doctors to look at the cancer on a cellular level. During the biopsy, the pathologist may use a technique called immunohistochemistry staining to help them distinguish sarcomatoid malignant mesothelioma from other types of cancer.
Can Sarcomatoid Mesothelioma Be Misdiagnosed?
Yes, sarcomatoid malignant mesothelioma can be misdiagnosed because this cancer shares symptoms with other diseases.
Sarcomatoid mesothelioma is commonly misdiagnosed as:
- Fibrous pleurisy
- Fibrous tumors
- Fibrosarcoma
- Metastasized renal sarcoma (kidney cancer)
- Non-Hodgkin’s lymphoma
- Pleural liposarcoma (cancer of the fat cells)
- Sarcomatoid carcinoma
- Soft tissue sarcomas
A mesothelioma misdiagnosis is dangerous because it can keep you from getting the right treatment to improve your life expectancy — or send you down a path of expensive and ineffective treatments. If you think you may have been incorrectly diagnosed, you should ask for a second opinion from a mesothelioma doctor.
Our Patient Advocates can help you get a second opinion from a top doctor in your area. Use our Free Doctor Match service to start the process — it only takes a few seconds.
Sarcomatoid Mesothelioma Life Expectancy
The sarcomatoid mesothelioma prognosis (overall outlook of the disease) is generally poor because of how quickly this cell type spreads to other parts of the body.
- The average life expectancy for sarcomatoid mesothelioma is 4-7 months.
- Sarcomatoid malignant mesothelioma has a 2-year survival rate of 15% (percentage of patients still alive 2 years after diagnosis).
Still, each case is unique, and your prognosis with sarcomatoid mesothelioma depends on your age, overall health, cancer stage, and other factors. Patients diagnosed in the early stages — before their cancer has a chance to spread — usually have more treatment options and may receive a better prognosis.
Subtypes of Sarcomatoid Mesothelioma
Although it’s uncommon, some patients have been diagnosed with a rare subtype of sarcomatoid mesothelioma. Pathologists can determine whether a patient has one of these sarcomatoid cell subtypes when reviewing their biopsy samples under a microscope.
Saracomatoid mesothelioma subtypes include:
- Desmoplastic mesothelioma: Recognized by the growth of dense, fibrous tissue
- Lymphohistiocytoid mesothelioma: Defined by unique inflammatory cells that look like immune system white blood cells called lymphocytes and histiocytes
- Transitional mesothelioma: Identified by cells that are both long and more rounded, combining features of both epithelioid and sarcomatoid types
Sarcomatoid Mesothelioma Treatment Options
Even though sarcomatoid mesothelioma tumors are more resistant to mesothelioma treatment than those of other cell types, there are still several options that patients can explore with their doctor.
Learn more about standard and emerging treatments for sarcomatoid malignant mesothelioma below.
Chemotherapy
Research shows chemotherapy can help keep sarcomatoid mesothelioma from spreading when used before or after surgery.
Chemotherapy medications currently approved by the U.S. Food and Drug Administration (FDA) for mesothelioma include pemetrexed in combination with cisplatin, both of which are now considered first-line (standard) treatments.
Immunotherapy
Immunotherapy for sarcomatoid malignant mesothelioma enhances the body’s immune system so it can destroy more tumor cells.
The FDA approved the immunotherapy drugs Opdivo® and Yervoy® (nivolumab and ipilimumab) in 2020 to treat pleural mesothelioma patients who aren’t eligible for surgery.
The approval came after the CheckMate 743 clinical trial found that immunotherapy helped sarcomatoid and biphasic mesothelioma patients live 4 months longer than those treated with chemotherapy.
A more recent clinical trial sponsored by the Alliance for Clinical Trials in Oncology is testing whether pre-surgery immunotherapy with Opdivo and Yervoy helps control cancer spread in the first three stages of sarcomatoid mesothelioma.
The trial is currently recruiting patients and should be completed in December 2026.
Surgery
Common surgeries used to treat pleural sarcomatoid mesothelioma include the pleurectomy with decortication (P/D), where the affected lung lining is removed, and the extrapleural pneumonectomy (EPP), which removes the entire lung, lung lining, and surrounding structures.
Peritoneal sarcomatoid mesothelioma patients may qualify for tumor-debulking followed by heated chemotherapy, a procedure commonly referred to as cytoreduction with HIPEC.
Sarcomatoid mesothelioma’s aggressive nature can limit the effectiveness of surgery. Additionally, complete tumor removal may not be possible due to the patient’s health and the stage of their cancer.
Get essential information on surgery, immunotherapy, and other ways to fight a sarcomatoid diagnosis in our Free Mesothelioma Guide.
Radiation Therapy
Radiation therapy for sarcomatoid mesothelioma involves using high-energy rays to target and destroy cancer cells. It’s a treatment option that can help shrink tumors, reduce symptoms, and slow down the progression of the disease.
During each treatment session, precise doses of radiation are directed at the affected area, damaging the DNA of cancer cells and preventing them from growing.
Radiation therapy may be used alone or in combination with other treatments like surgery and chemotherapy.
Emerging Treatments in Clinical Trials
The hope is to find potentially more effective treatments for sarcomatoid mesothelioma through clinical trials.
For example, the University of Chicago is currently studying how patients with sarcomatoid mesothelioma respond to the immunotherapy drug Keytruda®.
Other emerging treatment options for sarcomatoid mesothelioma include:
A mesothelioma doctor can determine the right treatment or clinical trials for you based on the location and stage of your sarcomatoid cancer.
Find Doctors Who Treat Sarcomatoid Malignant Mesothelioma
Confronting sarcomatoid mesothelioma is challenging, but having a strong support system makes all the difference. Our compassionate nurses and Patient Advocates have connections with top mesothelioma specialists and cancer centers nationwide.
Whether it’s getting you in to see the best surgeons or helping you seek financial assistance for treatment-related expenses, we’re here to make the journey easier on you and your family.
Reach out to us today at (866) 608-8933 or use our Free Doctor Match for personalized support when you need it most.
Mesothelioma With Sarcomatoid Cell Type FAQs
What is the most aggressive mesothelioma?
Sarcomatoid mesothelioma is the most aggressive type of this cancer. It’s the hardest to treat because the cancer cells are more resistant to therapies like surgery, chemotherapy, and radiation.
Sarcomatoid cells are also more likely to spread quickly to other parts of the body, leading to a poorer prognosis than other mesothelioma types, such as epithelioid and biphasic.
What is the prognosis for malignant mesothelioma with sarcomatoid type?
Sarcomatoid mesothelioma has an average prognosis of 4-7 months since it has a tendency to invade surrounding tissues and metastasize (spread) more rapidly.
As new treatments continue to be studied in clinical trials, there may be opportunities to improve outcomes in patients with sarcomatoid mesothelioma.
Call our team at (866) 608-8933 to learn more about joining a clinical trial and other ways to potentially improve your prognosis.
What is the survival rate for sarcomatoid mesothelioma?
According to a review of the National Cancer Database:
- The 2-year survival rate is 15%.
- This is the percentage of sarcomatoid mesothelioma patients alive 2 years after diagnosis.
- The 5-year survival rate is 5%.
- This is the percentage of sarcomatoid mesothelioma patients alive 5 years after diagnosis.
These rates are averages based on a large number of patients. Everyone responds differently to treatment, and it’s possible to beat the odds with the right medical care.
What is the surgery for sarcomatoid mesothelioma?
Surgery for sarcomatoid mesothelioma aims to remove as much cancerous tissue as possible. The type of surgery used will depend on various factors, including the location of your cancer.
The most common types of surgery include:
- Cytoreductive surgery with HIPEC: Combines tumor-removing surgery and heated chemotherapy applied to the abdominal cavity for peritoneal mesothelioma
- Extrapleural pneumonectomy (EPP): Extensive surgery that removes the cancerous lung, lung lining (pleura), and parts of the diaphragm and heart lining
- Pleurectomy with decortication (P/D): Removal of the pleura while preserving the lung
What is stage 4 mesothelioma with sarcomatoid cells?
In stage 4 mesothelioma with sarcomatoid cells, a patient’s cancer has spread extensively beyond the lung lining (pleura). This is the most advanced stage of mesothelioma.
Sarcomatoid cells are known for their long, slender shape and are one of the three main types of mesothelioma cells. The other two cell types are epithelioid and biphasic.
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