Familial mesothelioma: a puzzling issue

Abstract

Aim. The present study was conducted to collect data about familial mesothelioma, an occurrence once considered as exceptional and now reported with increasing frequency. Patients and methods. Eight cases of familial pleural mesothelioma were identified in various areas of Italy (the Tuscany Region and the Monfalcone district). The diagnosis was based on histological examination in six cases, and confirmed by necropsy in two of them. Occupational and social histories were obtained from the patients themselves or from their relatives by means of personal interviews. Asbestos bodies were isolated from the lung in the two necropsy cases, following the Smith and Naylor method. Results. The group included six men and two women, aged between 47 and 88 years. There were one couple father-son, one couple motherdaughter, one couple of brothers, and one couple of cousins. The male patients had been exposed occupationally to asbestos in various industries. The two women had histories of asbestos exposure at home, their husband-father having worked in a foundry. The latency periods (time intervals between first exposure to asbestos and diagnosis of the tumour) ranged between 34 and 56 years. Lung asbestos bodies isolated in the couple father-son were 55,000 and 169,000 per gram of dried tissue. Conclusions. In accordance with other studies, the present findings indicate that familiarity is not an alternative aetiologic explanation to asbestos. In their natural history, familial cases do not seem to differ from the sporadic ones. It remains doubtful whether mesothelioma among blood-related subjects may or may not indicate a genetic-based susceptibility to mesothelioma.