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Mesothelioma B005

Last amended 
14 September 2015

In this section

Current RMA Instruments:

Reasonable Hypothesis SOP
104 of 2015
Balance of Probabilities SOP
105 of 2015
Changes from Previous Instruments:

SOP Bulletin 185

ICD coding:

Pleural (ICD-9 163; ICD-10 C45.0)

Pericardium (ICD-9 164.1; ICD-10 C45.2)

Peritoneum (ICD-9 158.8; ICD-10 C45.1)

Brief description:

This is a primary malignant neoplasm of the mesothelial cells of the body. These cells line closed potential spaces of the body including the pleura, pericardium, peritoneum and the tunica vaginalis of the testis.  

Confirming the diagnosis:

To confirm the diagnosis there needs to be evidence on histology of the neoplasm.

The relevant medical specialist is an oncologist.

Conditions not covered by these SOPs   
  • Soft tissue sarcoma*

  • Hodgkin’s lymphoma*

  • NonHodgkin’s lymphoma*

  • Carcinoid tumour#

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

The assessment of the clinical onset begins with the confirmed diagnosis on histopathology, then goes back in time to the first confirmed imaging of the neoplasia, and then further back if possible, to the onset of reliable, contiguous clinical symptoms and signs which are pathognomonic of the neoplasm.   Clinical onset is typically a number of decades after relevant asbestos exposure.

Clinical worsening

For an aggravation to be relevant, there must be a clinical worsening out of keeping with the natural history of the underlying pathology.  Mesotheioloma is usually rapidly fatal once diagnosed and unresponsive or poorly responsive to treatment.  Inablity to obtain appropriate clincial management is unlikely to be relevant.