Mesothelioma.

Diagnostic Steps:

1. Pleural Biopsy: The definitive test to confirm the diagnosis of mesothelioma. Pleural biopsy provides tissue for histological examination, which is more accurate than cytology in diagnosing mesothelioma.

2. Imaging: Chest X-ray and CT scan of the chest to assess the extent of the disease.
Pulmonary Function Tests: To evaluate the impact on lung function.

Management:

Operable Disease:

. First Line: Surgery

. Plus: Pre- and/or postoperative chemotherapy

. Consider: Radiotherapy

Inoperable or Recurrent Disease:

i. First Line: Chemotherapy and/or immunotherapy

ii. Consider: Radiotherapy

iii. Consider: Palliative procedures and supportive care

iv. Long-term Indwelling Pleural Drain: For managing malignant pleural effusion and relieving symptoms.

v. Chemotherapy and Radiotherapy: As part of the treatment plan for malignant mesothelioma.

vi. Surgical Intervention: In select cases, surgery may be an option to remove the tumour.

vii. Palliative Care: To manage symptoms and improve quality of life.