Biopsy is one of the most essential tools for diagnosing mesothelioma, but some patients have conditions that put the procedure out of reach. Weakened condition and severe adhesions can make biopsy’s accompanying general anesthesia too dangerous, leaving patients with uncertainty and unclear treatment paths. According to a new case report published in Respirology Case Reports, specialists in Japan who faced this dilemma treated a medically frail patient using a minimally invasive technique, offering hope for patients unable to withstand more invasive diagnostic surgery.
Mesothelioma Patient Faced High Surgical Risk
The report details the case of a 65-year-old construction worker suspected of having pleural mesothelioma. The man, who had a history of asbestos exposure, had experienced significant weight loss and was suffering from chest pain. Imaging revealed pleural thickening and calcified plaques that pointed to the rare, asbestos-related cancer, but severe adhesions between the lung and chest wall, along with declining lung function and physical strength, made general anesthesia too risky, as standard surgical biopsy could lead to further decline for the patient.
Instead of the tissue biopsy that is typically used in a mesothelioma diagnosis, the medical team chose instead to use local anesthesia thoracoscopy. Usually, this technique isn’t used in patients whose adhesions are extensive, but by combining CT scans, PET imaging, and ultrasound, they were able to pinpoint the exact location of the tumor. They made a small incision directly over it, which minimized the need to disrupt adhesions that were found in other spots throughout the patient’s chest.
Doctors Use Cryobiopsy to Collect Mesothelioma Tissue
Tissue from the patient’s mesothelioma tumor was successfully collected using a tool called a cryoprobe, which freezes and extracts samples with minimal damage compared to traditional biopsy tools. The surgical team extended the freezing time beyond what’s typically used in similar procedures, using direct compression to control bleeding. The procedure, which confirmed the mesothelioma diagnosis, took just 58 minutes, and the patient was walking within two hours. He was discharged the next day, and treatment began 22 days later, with the patient prescribed a combination of immunotherapy drugs. He was progression free eight months later.
Mesothelioma Patients May Benefit from Similar Approaches
This case suggests that patients facing these challenges may still receive a definitive mesothelioma diagnosis, without undergoing higher-risk surgery, by using careful imaging and a targeted approach. The study’s authors say this patient’s success may establish another option for patients whose adhesions or overall health otherwise rule out diagnostic surgery.
If you or someone you love has been diagnosed with mesothelioma or the rare asbestos-related disease is suspected, the Patient Advocates at Mesothelioma.net can help. Contact us today at 1-800-692-8608 to learn more.