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Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma is a rare form of cancer typically found in the lungs. It is the least common type of mesothelioma. The cells can spread to other areas of the body, and this form of cancer does not respond well to treatment. It usually progresses rapidly and is considered terminal.

Key Facts About Sarcomatoid Mesothelioma

  • About 10% to 20% of mesotheliomas are sarcomatoid.
  • People with sarcomatoid mesothelioma have a median survival of 7 months.
  • These cells are aggressive and more difficult to treat.
  • The cells have sarcoma-like features and usually look spindle-shaped under a  microscope.
  • Surgery is typically not an option for sarcomatoid mesothelioma.

What Is Sarcomatoid Mesothelioma?

Sarcomatoid mesothelioma is a rare form of mesothelioma, cancer that develops in the membrane tissue surrounding and protecting organs in the chest, abdomen, and pelvis.

It is more aggressive and more likely to be diagnosed at an advanced stage than epithelial mesothelioma. This type of cancer often has fewer treatment options.

Sarcomatoid mesothelioma is characterized by the presence of sarcoma-like features in the pleural or peritoneal mesothelial cells.

What Do Sarcomatoid Cells Look Like?

Sarcomatoid mesothelioma cells have sarcoma-like features and typically look spindle-shaped under a microscope.

The spindle shape of sarcomatoid cells makes it difficult for them to stick together, meaning they are more likely to break off from the tumor and spread to other areas of the body. Therefore, sarcomatoid cells tend to metastasize, which means cancer can spread to other parts of the body, such as bone, muscle tissues, or other organs.

Sarcomatoid Mesothelioma Subtypes

There are a number of subcategories of sarcomatoid mesothelioma. Because sarcomatoid mesothelioma is so rare in itself, the subtypes may be even rarer. This means that there may be little research into each individual subtype.

Desmoplastic Mesothelioma

Desmoplastic mesothelioma is a rare subtype of diffuse malignant mesothelioma. It is often difficult to distinguish from reactive pleural fibrosis. According to one study, the median survival time of sarcomatoid-type mesothelioma is 5.5 months. The study continues by saying that desmoplastic mesothelioma also has a poor prognosis, but the rarity of this subtype means that its detailed characteristics are poorly known.

Transitional Mesothelioma

Sometimes it can be difficult for doctors to distinguish between transitional and metastatic carcinoma cells because they look very similar under the microscope.

Sarcomatoid mesothelioma cells are typically spindle-shaped. However, not all sarcomatoid cells are. When the sarcomatoid cells become more rounded, they can be mistaken for sarcoma or adenocarcinoma. As a result, these types of tumors remain less common than their spindle-shaped counterparts in the mesothelium.

Lymphohistiocytoid Mesothelioma

Lymphohistiocytoid mesothelioma is a rare subtype of mesothelioma that makes up less than 1% of all asbestos-related cases.

It was first discovered in 1988 and is characterized by its dense bundles of inflammatory and immune cells. Some researchers suggest that this should be categorized as epithelial mesothelioma rather than sarcomatoid, as it shares some of the same characteristics, but for now, it remains a sarcomatoid subtype.

What Causes Sarcomatoid Mesothelioma?

The cause of sarcomatoid mesothelioma is exposure to asbestos. It usually takes 10-40 years for sarcomatoid mesothelioma to develop after being exposed to asbestos.

It can also be caused by exposure to other materials that contain asbestos, such as cement, textiles, and insulation.

The most common way of being exposed to asbestos is when the fibers are disturbed and released into the air. This can happen when people disturb asbestos materials during construction or demolition work or when they accidentally bring them home on their clothes or shoes. However, people may also be exposed to asbestos if they live in an area with naturally high levels of asbestos.

Symptoms of Sarcomatoid Mesothelioma

Symptoms of sarcomatoid mesothelioma are similar to the symptoms of other types of mesothelioma. They include:

  • coughing
  • coughing up blood
  • fatigue
  • fever
  • heart murmur
  • irregular bowel movements
  • low appetite
  • lumps under the skin on the chest
  • nausea or vomiting
  • shortness of breath
  • unexplained weight loss
  • weakness

Because sarcomatoid mesothelioma often metastasizes, meaning that it spreads throughout the body easily, symptoms may be nonspecific. This means that they could be confused for a number of other conditions before doctors eventually diagnose them correctly.

How is Sarcomatoid Mesothelioma Diagnosed?

The diagnosis process for sarcomatoid mesothelioma can be challenging because it shares many features with other, more common cancers.

The diagnosis of sarcomatoid mesothelioma is usually made by a combination of tests, including:

  • Blood tests
  • Chest x-ray
  • Computed tomography (CT) scan
  • Echocardiogram
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  • Tissue biopsy

Doctors will use these tests to rule out other cancers before diagnosing sarcomatoid mesothelioma based on various factors, including age, gender, tumor location, and symptoms.

What are the Treatment Options for Sarcomatoid Mesothelioma?

Sarcomatoid cell mesothelioma is aggressive and more likely to be diagnosed at an advanced stage of mesothelioma. It forms less clear-cut edges than other types of mesothelioma and is more difficult to treat.

The treatment for sarcomatoid mesothelioma may vary depending on the severity. If the cancer is still localized, then surgery may be an option. However, chemotherapy and radiation therapy may be the best option if it has already metastasized.

Doctors will base their treatment recommendations on your circumstances and work with you to devise the best treatment plan for your sarcomatoid mesothelioma.


Chemotherapy is a cancer treatment that uses drugs to kill cancer cells. Chemotherapy may be given in cycles, with periods of rest in between, or it may be a continuous treatment. Chemotherapy can be used as a treatment for sarcomatoid mesothelioma, and it is often used with other treatments.

Some of the common side effects of chemotherapy are hair loss, nausea, vomiting, and fatigue.

Radiation Therapy

Radiation therapy is a type of cancer treatment that uses high-energy rays to kill cancer cells and stop them from growing. It is often used with chemotherapy to kill any remaining cancer cells. Radiation therapy may be used alone or in combination with other treatments.

Radiation therapy for sarcomatoid mesothelioma has been studied for years, but there are still many unanswered questions about how it works and how well it works.


Surgery is rarely an option for sarcomatoid mesothelioma because by the time it is diagnosed, the cancer has usually spread to other areas of the body. This means that it would be too difficult to remove the tumor with surgery.

What is the Prognosis for Sarcomatoid Mesothelioma?

When grouped by cell type, sarcomatoid mesothelioma is the least common type of mesothelioma but is the most aggressive. In a 2010 study, the average survival rate was 3.5 months. Still, as advances in treatment options have been made since then, new treatments such as immunotherapy may be able to increase the average survival rate.


Read on to learn the answers to a number of frequently asked questions regarding sarcomatoid mesothelioma.

What is the survival rate of sarcomatoid mesothelioma?

Sarcomatoid mesothelioma is a rare and deadly form of cancer that develops from mesothelial cells. It is less common than other types of mesothelioma and more aggressive. Sarcomatoid mesothelioma has a median survival of 7 months.

What does sarcomatoid mean?

The word sarcomatoid means “fibrous tissue that resembles the spindle-cell sarcoma.” This type of cancerous tumor can be found in the pleura, peritoneum, pericardium, or skin. It is also known as malignant mesothelioma.

What are sarcomatoid features?

The sarcoma-like cells are often spindle cells. Under a microscope, spindle cells look long and slender.

Is sarcomatoid mesothelioma painful?

Sarcomatoid cells are most common in malignant pleura mesothelioma and start to impact the lining of the lungs. This can lead to symptoms like chest pain and shortness of breath. People may also experience pain if the tumor grows to such a size that it begins to press on other structures in the body, such as nerve endings.

Where does sarcomatoid mesothelioma start?

Sarcomatoid mesothelioma is a rare type of cancer that starts in the lining of the lungs or abdomen. The word “sarcomatoid” means it has features like both sarcoma and mesothelioma.

Next Steps

The first step for sarcomatoid mesothelioma is to get an accurate diagnosis. This can be done with a biopsy.

The next step is to talk with your doctor about the type of treatment you may need. Treatment options depend on whether the cancer has spread and how far it has spread.

The third step is to talk about treatment options with your family and friends so that they can help you through this difficult time.

In some cases, surgery may be recommended to remove the tumor or tumors in order to try to cure the cancer. If surgery isn’t an option, then radiation therapy may be used in combination with chemotherapy or other treatments like targeted therapy or immunotherapy.