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Malignant pleural mesothelioma — SCE Respiratory MCQ

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HardLung CancerMalignant pleural mesotheliomaSCE Respiratory

A 73-year-old former asbestos worker has pleural thickening and biopsy-proven epithelioid mesothelioma. CT shows disease confined to one hemithorax but he has ECOG performance status 2 and TLCO 38% predicted. What is the most appropriate management?

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Correct answer: D — Mesothelioma MDT discussion for systemic treatment and symptom-directed pleural care

Mesothelioma should be managed through a specialist MDT, with systemic therapy and pleural symptom control tailored to performance status and physiology. Radical surgery is not routine first-line treatment and is unsuitable for many patients with limited reserve. EGFR therapy, withholding symptom control and TB treatment are inappropriate.

Reference: BTS Mesothelioma Guideline; NICE NG122