Occupational Malignant Mesothelioma in Thailand

Abstract

Malignant mesothelioma is an occupational cancer among workers exposed to asbestos in workplace environment. The latency period, starting from asbestos exposure to clinical manifestation of the disease, is between 20 - 40 years. This report describes a case of malignant mesothelioma. He was a 75-year-old Thai man who was occupationally exposed to asbestos for 24 years and quit this job 22 years ago. Four months prior to his death, the patient had progressive dyspnea and medical consultation was sought. Both pulmonary roentgenography (CXR) and computerized tomography (CT) revealed multiple pleural nodules in the right lung. Fine needle aspiration, confirmed by core needle biopsy, suggested non-small cell carcinoma of lungs. Due to the specific location of the abnormal nodules, the attending oncologist suspected malignant mesothelioma. His occupational history was reviewed and an immuno-histochemical study of the specimens was requested. Slides revision was performed by a pulmonary pathologist before the final diagnosis was given as malignant mesothelioma. Asbestos had been imported and used by several industries in Thailand for the last three decades. However, there had never been reports on malignant mesothelioma nor other asbestos-related diseases. This patient could be the turning point of the so-called ‘asbestos epidemic’ in the near future.