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Mesothelioma Misdiagnosis

Malignant mesothelioma is often misdiagnosed as health conditions like emphysema, pneumonia, lung cancer, and ovarian cancer because it is rare and does not always have specific symptoms. Many doctors are unlikely to suspect this form of cancer unless the patient has a history of asbestos exposure. Seeing a cancer doctor is the best way to avoid a mesothelioma misdiagnosis.

Medically reviewed by: Assuntina Sacco, MD

Last updated:

What Is a Mesothelioma Misdiagnosis?

A mesothelioma misdiagnosis occurs when doctors mistake signs or symptoms of this cancer for another condition.

About 14% of all mesothelioma cases in the United States are misdiagnosed, according to the American Cancer Society Journals. This percentage is closer to 25% in pleural mesothelioma cases.

An incorrect mesothelioma diagnosis is more likely to happen when doctors are unaware of a patient’s history of asbestos exposure — especially because this cancer is so rare and shares symptoms with more common health problems.

Below are the four types of mesothelioma and their common misdiagnoses.

Pleural Mesothelioma

  • Adenocarcinoma
  • Breast cancer
  • Bronchitis, pneumonia, and other chest infections
  • Chronic obstructive pulmonary disease (COPD)
  • Emphysema
  • Pleural plaques (buildup of collagen in the lung lining)
  • Other respiratory conditions

Peritoneal Mesothelioma

  • Crohn’s disease
  • Gallstones
  • Irritable bowel syndrome (IBS)
  • Ovarian cancer
  • Other abdominal conditions

Pericardial Mesothelioma

  • Cardiomyopathy (disease that affects the heart muscle)
  • Congestive heart failure
  • Coronary heart disease
  • Pericarditis (inflammation of the heart lining)
  • Other cardiac conditions

Testicular Mesothelioma

  • Epididymitis (swelling of tube at back of testicles)
  • Hernia
  • Prostate cancer
  • Spermatocele (spermatic cysts)

Fortunately, you can take action today to get an accurate diagnosis. Find top doctors who can properly diagnose and treat mesothelioma in our Free Mesothelioma Guide, shipped overnight.

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What Should I Do If I Might Have Been Misdiagnosed?

Get a second opinion from a mesothelioma specialist immediately if you believe you’ve been misdiagnosed, especially if you were exposed to asbestos in the past. Make sure you tell your doctor about your asbestos exposure history.

A doctor experienced in diagnosing and treating mesothelioma patients can determine whether you have this type of cancer.

An incorrect diagnosis gives the cancer more time to spread throughout your body and delays your treatment. Without treatment, the life expectancy for mesothelioma can be as short as a few months.

The stories of mesothelioma survivors like Mary Jane Williams show how important it is to be persistent if you or a family member is struggling to get answers to unexplained health problems.

Mary Jane spent a year suffering from abdominal bloating, experienced a 20-pound weight loss, and was prescribed medication for gastroesophageal reflux disease (GERD). She visited several doctors before being correctly diagnosed with peritoneal mesothelioma at age 56.

“You have to just keep going until you find the answers you’re seeking. If you’re not happy with your doctor, go someplace else.”
– Mary Jane Williams, 15-year peritoneal mesothelioma survivor

Pleural Mesothelioma Misdiagnosis

Since malignant pleural mesothelioma is a rare form of cancer, it is frequently confused with other illnesses.

Nearly 1 in 4 pleural mesothelioma patients are misdiagnosed at first, according to a report from The Open Epidemiology Journal.

Sadly, failure to diagnose pleural mesothelioma can delay treatment and affect a patient’s prognosis.

Early-Stage Pleural Mesothelioma Misdiagnosis

A doctor reviews a chest X-ray with a mesothelioma misdiagnosis patientIn its earlier stages (stages 1 and 2), pleural mesothelioma is extremely difficult to diagnose. As a result, it is commonly misidentified as other respiratory conditions with similar symptoms.

Learn more about common misdiagnoses for early-stage pleural mesothelioma.


Emphysema occurs when the alveoli (tiny air sacs in the lungs) become damaged. Like mesothelioma, the condition gets progressively worse over time.

Emphysema is typically recognized by two common symptoms — shortness of breath and a chronic cough. These are also common symptoms of pleural mesothelioma.

Other symptoms pleural mesothelioma and emphysema share include:

  • Chest pain
  • Fatigue
  • Loss of appetite
  • Lung infections
  • Wheezing

Bronchitis and Chest Infections

Bronchitis and chest infections have many of the same symptoms as early-stage pleural mesothelioma.

Symptoms shared by all three conditions include:

  • Coughing
  • Difficulty breathing
  • Fatigue
  • Fluid build-up around the lungs (pleural effusion)
  • Fever

However, bronchitis and chest infections are typically caused by viruses. Pleural mesothelioma, on the other hand, develops when asbestos fibers cause cancerous cell mutations in the lung lining (pleura).

Chronic Obstructive Pulmonary Disease (COPD)

Early-stage pleural mesothelioma may also be mistaken for COPD, a condition in which the lungs are damaged after exposure to irritants.

COPD, which is commonly associated with smoking, is characterized by a chronic, phlegmy cough nicknamed “smoker’s cough.” Chest tightness, wheezing, and shortness of breath are other common symptoms of COPD.

While smoking can certainly worsen pleural mesothelioma symptoms, the only known cause of this cancer is asbestos exposure.

Late-Stage Pleural Mesothelioma Misdiagnosis

It’s still possible for a doctor to fail to diagnose pleural mesothelioma when a patient displays late-stage (stages 3 and 4) mesothelioma symptoms or after a cancerous tumor is discovered.

In many cases, advanced-stage pleural mesothelioma is confused with a different type of cancer like lung cancer or adenocarcinoma. In some cases, it is diagnosed as pleural plaques, which are not a form of cancer but also stem from asbestos exposure.

Lung Cancer

The damage pleural mesothelioma causes to the lung, as well as the tumors that appear, can be misdiagnosed as lung cancer.

While both pleural mesothelioma and lung cancer can be treated with surgery, pleural mesothelioma is often more aggressive and may require specific supplemental treatment options, such as heated chemotherapy.


Adenocarcinoma is another form of cancer caused by tumors in the glands that line the lungs and other organs.

Mesothelioma behaves in a very similar manner to adenocarcinoma, which makes it possible for even experienced oncologists (cancer doctors) and surgeons to confuse the two cancers.

Pleural Plaques

People exposed to asbestos may develop pleural plaques, a noncancerous condition in which a chalky substance builds up on the pleura.

Because mesothelioma and pleural plaques are both located in the lung lining and caused by asbestos exposure, it’s possible for doctors to mistake pleural plaques for pleural mesothelioma

However, the most notable difference is that pleural plaques are benign (harmless) and don’t cause any symptoms. Make sure to get a second opinion if doctors only find pleural plaques and you’re feeling unwell.

Learn more about the early warning signs of mesothelioma and how to get a second opinion — request our Free Mesothelioma Guide now to have it shipped overnight to your doorstep.

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Peritoneal Mesothelioma Misdiagnosis

Peritoneal mesothelioma doesn’t have one or two obvious symptoms like pleural mesothelioma. Instead, it shares symptoms with many other illnesses, making it easy for medical professionals to mistake it for more common illnesses or types of cancer.

Nonspecific peritoneal mesothelioma symptoms include:

  • Abdominal pain and swelling (distention)
  • Ascites (fluid buildup in abdomen)
  • Constipation
  • Fatigue
  • Nausea and vomiting
  • Night sweats
  • Weight loss

Illnesses commonly mistaken for peritoneal mesothelioma include:

  • Irritable bowel syndrome (IBS): IBS and mesothelioma share symptoms of abdominal pain, bloating, and constipation.
  • Crohn’s disease: Crohn’s disease is an inflammatory bowel disease that causes pain and inflammation in the gastrointestinal (GI) tract, which can mimic the abdominal discomfort associated with peritoneal mesothelioma.
  • Gallstones: These solid lumps of digestive fluid form in the gallbladder and cause abdominal pain, nausea, and other symptoms similar to peritoneal mesothelioma.
  • Ovarian cancer: Peritoneal mesothelioma can be easily mistaken for ovarian cancer as patients with both conditions often experience abdominal-related symptoms such as ascites, abdominal distention, and stomach pain.
Julie's Story

Julie Gundlach, a 17+ year survivor, visited a doctor after experiencing digestive issues and ultimately underwent surgery for a pelvic mass that was thought to be ovarian cancer. It wasn’t until after her surgery that she was diagnosed with peritoneal mesothelioma in 2006.

If you suspect a peritoneal mesothelioma misdiagnosis or have already been diagnosed, it’s important to get a second opinion from an experienced specialist so you can start receiving proper treatment.

Misdiagnosing Mesothelioma Stage

Even if a doctor identifies a patient’s condition as mesothelioma, there can still be a misdiagnosis when it comes to determining the disease stage.

Treating mesothelioma at different stages requires different approaches, which means that misdiagnosing the mesothelioma stage can be just as harmful as a misdiagnosis of the disease itself.

Typically, only patients whose cancer is localized (early-stage) can undergo life-extending surgery to remove their tumors. Patients with advanced (late-stage) cancer are usually ineligible for surgeries that can improve their life expectancy.

Mesothelioma doctor speaking to an elderly male about their treatment plan

Proper diagnosis of the stage helps ensure that patients can access the most effective mesothelioma treatments — including new, cutting-edge treatment options available in clinical trials.

We can help you connect with top specialists who can properly diagnose and treat your stage of mesothelioma. Get started right now with our Free Doctor Match.

How Is Mesothelioma Misdiagnosed?

Because mesothelioma is so rare — about 3,000 Americans are diagnosed with this cancer each year — it is not usually the first thing that comes to a doctor’s mind when a patient reports their symptoms.

Here’s how mesothelioma misdiagnoses can occur:

  • When viewed under a microscope, mesothelioma cells may resemble other metastatic (advanced) cancer cells. Doctors may also misdiagnose a patient’s mesothelioma cell type in some cases.
  • Pathologists test fluid or tissue samples using specialized “stains” to indicate whether cancer is present. However, staining patterns alone can lead to the wrong diagnosis without considering other features of the tumor and the patient’s medical history.
  • Even though imaging tests like CT scans (computed tomography scans) and X-rays are generally reliable when identifying common cancers, mesothelioma is so rare that a biopsy is needed to see the full picture.

A tissue biopsy is the only way to confirm a mesothelioma diagnosis.

How to Avoid a Mesothelioma Misdiagnosis

Obtaining the correct diagnosis helps doctors tailor a patient’s treatment plan to their cancer, giving them a better chance of survival.

That being said, if you or a loved one may have mesothelioma — or suspect that your current diagnosis is incorrect — it is important to visit a mesothelioma specialist.

Even if you’ve already consulted your primary doctor, if you were previously exposed to asbestos and have symptoms of mesothelioma, getting a second opinion from a specialist helps ensure you can access the best treatment options possible.

The Mesothelioma Hope team can help you find top doctors to properly diagnose you and provide life-extending treatments. Try our Free Doctor Match or get help right now by calling us at (866) 608-8933.

Mesothelioma Misdiagnosis FAQs

Can mesothelioma be misdiagnosed?

Yes, mesothelioma can be misdiagnosed as bronchitis, pneumonia, a hernia, irritable bowel disease, and other types of cancer like lung cancer and ovarian cancer.

Nearly 1 in 4 pleural mesothelioma patients receive an incorrect diagnosis at first, according to a report from The Open Epidemiology Journal.

More broadly, the American Cancer Society Journals found that 14% of all mesothelioma cases are misdiagnosed in the United States and other Western countries. That rate increases to 50% in less developed countries that don’t have the best health care available.

Why is mesothelioma so hard to diagnose?

Mesothelioma is hard to diagnose for three distinct reasons:

  • Long latency period: Mesothelioma has a long latency period, which means that the time between asbestos exposure and the development of symptoms or diagnosis can be several decades (typically 10-50 years). This delay makes it difficult for doctors to connect a patient’s symptoms with their exposure history.
  • Non-specific symptoms: In its early stages, mesothelioma often presents with mild and non-specific symptoms, such as fatigue, chest pain, and a persistent cough. These symptoms can easily be attributed to other common conditions, leading to a mesothelioma misdiagnosis or a delayed diagnosis.
  • Similarity to other conditions: Many of the symptoms of mesothelioma, such as pleural effusions (fluid buildup in the chest), shortness of breath, and weight loss, can be seen in other lung and respiratory conditions, making it challenging to distinguish mesothelioma from these illnesses.

What can mimic mesothelioma?

Many health problems can mimic mesothelioma.

For example, people with pleural mesothelioma are often diagnosed with respiratory illnesses like bronchitis, chronic obstructive pulmonary disease (COPD), or lung cancer. Both conditions share symptoms like chest pain, pleural effusion (fluid around the lungs), and a recurring cough.

People with peritoneal mesothelioma are often diagnosed with irritable bowel syndrome, Crohn’s disease, and ovarian cancer. All of these conditions share abdominal-related symptoms like swelling and constipation.

What disease is similar to mesothelioma?

Diseases that are similar to mesothelioma in symptom presentation include emphysema, pneumonia, and lung cancer (pleural mesothelioma) and Crohn’s disease, irritable bowel syndrome, and ovarian cancer (peritoneal mesothelioma).

As a result, it is common for doctors to mistakenly diagnose one of these illnesses as mesothelioma.

What test confirms mesothelioma?

The confirmatory test for mesothelioma is a biopsy, according to Penn Medicine. These tests gather fluid of tissue samples that are examined under a microscope for cancer cells.

Once a diagnosis of mesothelioma is confirmed, the patient can discuss different treatment options and other health information with their doctor.

Dr. Assuntina SaccoReviewed by:Assuntina Sacco, MD

Board-Certified Oncologist

  • Fact-Checked
  • Editor

Assuntina Sacco, MD is an Associate Professor of Internal Medicine at the University of California, San Diego (UCSD) Moores Cancer Center, where she also serves as the Medical Director of Infusion Services. She is a board-certified medical oncologist trained to treat all solid tumor types, with the use of chemotherapy, immunotherapy, targeted therapy, and clinical trials.

Dr. Assuntina Sacco is an independently paid medical reviewer.

  • Board-Certified Oncologist
  • Associate Professor at UC San Diego
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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  2. Drevinskaite, M., Patasius, A., Kevlicius, L. et al. Malignant mesothelioma of the tunica vaginalis testis: a rare case and review of literature. BMC Cancer 20, 162 (2020). Retrieved February 2, 2024, from
  3. Framarino-dei-Malatesta M, Sammartino P, Derme M, Iannini I, Masselli G, Pecorella I. Breast cancer or metastasis? An unusual case of metastatic malignant pleural mesothelioma to the breast. World J Surg Oncol. 2015 Feb 25;13:79. Retrieved February 2, 2024, from doi: 10.1186/s12957-015-0491-z
  4. Frontiers in Genetics. (n.d.). Tumors that mimic asbestos-related mesothelioma: time to consider a genetics-based tumor registry? Retrieved February 2, 2024, from
  5. Hancock KL, Clinton CM, Dinkelspiel HE, Saab J, Schneider B, Caputo TA. A case of mesothelioma masquerading pre-operatively as ovarian cancer and brief review of the literature. Gynecol Oncol Rep. 2016 Apr 26;17:26-8. Retrieved February 2, 2024, from doi: 10.1016/j.gore.2016.04.003
  6. Kopylev, L., Sullivan, P., & Et al. (n.d.). Monte Carlo Analysis of Impact of Underascertainment of Mesothelioma Cases on Underestimation of Risk. Retrieved February 2, 2024, from
  7. Penn Medicine. “Mesothelioma Diagnostic Tools and Tests.” Retrieved February 2, 2024, from
  8. Savarrakhsh, A., Vakilpour, A., Davani, S.ZN. et al. Malignant primary pericardial mesothelioma presenting as effusive constrictive pericarditis: a case report study. J Cardiothorac Surg 16, 298 (2021). Retrieved February 2, 2024, from
  9. Wang, L., Zhang, J., Chen, X., Liang, M., Li, S., Zhou, W., & Cao, J. (2021, November 12). Pulmonary sarcomatoid carcinoma mimicking pleural mesothelioma: A case report. Retrieved February 2, 2024, from
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