Biphasic pleural mesothelioma in a electrician working in a railway company: case report and current trends in mesotheliomas in Italy

Background: Mesothelioma is an aggressive tumour that can involve the pleura, the peritoneum, and sometimes other mesothelia, such as the pericardium and the tunica vaginalis testis. Scientific communities have known for a long time the causal correlation between exposure to asbestos (work related or not) and the onset of the disease (in 75% - 90% of cases) and the increasing number of asbestos-correlated mesotheliomas expected in the next years. Case presentation: The authors present the case of an electrician, 66-year-old man, died for pleural mesothelioma, working in Palermo in the company of the Italian Railways for a period of about 20 years, exposed to asbestos. Frequently he disassembled and reassembled the ceiling lights in the train carriages and worked in the same workplace where it was made the asbestos removal from train carriages. The autopsy showed a biphasic pleural mesothelioma, with mainly polymorphic desmoplastic-sarcomatous aspects, infiltrating the lung parenchyma, with areas of septal fibrosis and multiple outbreaks of pneumonia and edema. Conclusions: It is fundamental to know workers' risks to formulate a correct etiopathogenetic diagnosis, as in this presented case, not apparently in connection with asbestos (electrician worker). Because of the long latency in the genesis of mesothelioma after asbestos exposure (both because of the work and environmental pollution), it is considered appropriate to increase in Italy the activities of the regional centres of the Health System dedicated to health promotion and health surveillance of the former exposed to asbestos, created and active, unfortunately, only in some regions of our Country.