Overview
Sarcomatoid cells grow fast and spread aggressively. They resist chemotherapy better than other types. Patients face a more challenging prognosis, but immunotherapy trials are showing promise.
Characteristics
- Spindle-shaped, elongated cells
- Irregular, disorganized growth patterns
- Rapid growth rate
- High tendency to spread (metastasize)
- Most resistant to chemotherapy
- Often diagnosed at advanced stages
Subtypes
Transitional
Intermediate between epithelioid and sarcomatoid
Lymphohistiocytoid
Contains inflammatory cells; may have slightly better prognosis
Desmoplastic
Dense fibrous tissue; very difficult to diagnose
Diagnosis
Accurate cell type identification is critical for treatment planning. Diagnosis typically involves:
- Tissue biopsy required (larger sample often needed)
- Immunohistochemistry less reliable than for epithelioid
- May be confused with other sarcomas or fibrous tumors
- Genetic testing can help confirm diagnosis
- Expert pathology review strongly recommended
Treatment Options
Treatment for sarcomatoid mesothelioma may include:
- Surgery rarely recommended due to aggressive nature
- Chemotherapy may slow progression but lower response rates
- Immunotherapy showing promise in some patients
- Clinical trials may offer access to new treatments
- Palliative care important for symptom management
Prognosis
The aggressive nature of sarcomatoid cells leads to shorter survival times. But some patients respond well to immunotherapy. Clinical trials are testing new targeted treatments that may improve outcomes.
Learn about mesothelioma prognosis factors →Getting a Second Opinion
Because cell type significantly affects treatment options and prognosis, obtaining a second opinion on your pathology results from a mesothelioma specialist is often recommended. Pathologists with mesothelioma experience are more likely to accurately identify cell type, subtypes, and any unusual features that may affect your treatment plan.