Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma is a rare type of mesothelioma cell. It is the most aggressive of all three cell types. These cells are spindle-shaped, meaning they can spread quickly throughout the body. Thankfully, there are still treatments available for those diagnosed. Learn more and find out how our team can help after a sarcomatoid mesothelioma diagnosis.

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What Is Sarcomatoid Mesothelioma?

Sarcomatoid mesothelioma accounts for approximately 9% of all mesothelioma tumors. It is the least common of all three mesothelioma cell types and is the hardest to treat.

drawing of sarcomatoid mesothelioma cells
Illustration of sarcomatoid mesothelioma cells

Sarcomatoid tumors are characterized by spindle cells. These cells are more likely than other mesothelioma cell types to spread to other parts of the body, as they don’t stick together as well as other mesothelioma cells do.

Like other cancerous tumors, sarcomatoid mesothelioma tumors can spread to other parts of the body in a process known as metastasis.

Those diagnosed with sarcomatoid mesothelioma have the poorest prognosis (health outlook) of all three cell types. This is because the cancer spreads so quickly and doesn’t respond as well to mesothelioma treatments.

That said, it’s still possible to get medical care for sarcomatoid mesothelioma and live longer than expected. Download our Free Mesothelioma Guide to learn more.

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Sarcomatoid Mesothelioma vs. Other Types of Mesothelioma

Sarcomatoid mesothelioma is rarer and more aggressive than the other two mesothelioma cell types: epithelioid mesothelioma and biphasic mesothelioma.

  • Also known as epithelial mesothelioma, epithelioid mesothelioma is the most common type of mesothelioma cell. It accounts for 75% of mesothelioma cancer cases. The square-shaped cells stick together, meaning they don’t spread as quickly and are easier to treat.
  • Biphasic mesothelioma tumors consist of a mix of epithelioid and sarcomatoid cells. Biphasic tumors that mainly consist of sarcomatoid mesothelioma cells are more aggressive than those with mostly epithelial mesothelioma cells.

It’s important to remember that medical care can help you no matter which mesothelioma cell type you have.

Sarcomatoid Mesothelioma Causes

As with other types of mesothelioma, the only known cause of sarcomatoid mesothelioma is asbestos exposure.

When inhaled or swallowed, asbestos fibers might get stuck inside the linings of major organs. The fibers may never leave the body and can cause long-term irritation and scarring.

This damage eventually leads to mesothelioma, usually 10-50 years after initial exposure.

Sarcomatoid mesothelioma may be associated with higher rates of exposure to asbestos fibers.

A Modern Pathology study found a median of 1,640 asbestos bodies (fibers coated with bodily proteins) per gram of lung tissue in sarcomatoid patients. In contrast, patients with non-sarcomatoid mesothelioma had an average of 348 asbestos bodies per gram.

Symptoms of Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma symptoms depend on the cancer stage, where the tumors form in the body, and other factors. Early-stage symptoms are often nonspecific and may be misdiagnosed as those of less serious conditions.

Common early-stage symptoms include:

  • Chest pain
  • Coughing
  • Shortness of breath

As the cancer grows and spreads, more symptoms may appear.

Possible signs of advanced mesothelioma include:

  • Blood in vomit and feces
  • Bloody sputum
  • Fatigue
  • Pleural effusion (fluid buildup in lung lining)
  • Shoulder pain
  • Upper back pain
  • Unintended weight loss
  • Weakness

Make sure to see a doctor immediately if you have any of these symptoms and were exposed to asbestos 10-50 years ago, as you could have sarcomatoid mesothelioma or another form of this cancer.

Addressing symptoms quickly is key, as your doctors may be able to diagnose you while the cancer is still easy to treat. Sadly, the cancer is already advanced in many cases by the time patients develop noticeable or worrisome mesothelioma symptoms.

Call (888) 360-2406 to get help for possible symptoms of sarcomatoid mesothelioma now.

Diagnosing Sarcomatoid Mesothelioma

If your health care provider suspects you have mesothelioma, they will take several steps to confirm the diagnosis. Common methods oncologists (cancer doctors) use to diagnose mesothelioma include physical exams, imaging scans, and biopsies.

Physical exams help doctors take note of symptoms. Make sure to tell your doctor when your symptoms started and if you worked with or around asbestos.

Using this information, doctors can start to narrow down if the symptoms are related to mesothelioma or not. They may then order tests to check for signs of mesothelioma.

These tests include:

  • Blood tests: These are also known as immunohistochemistry lab tests, which use antibodies to identify signs of sarcomatoid mesothelioma, such as the protein calretinin, in the blood.
  • Computerized tomography (CT) scans: CT scans use computers and X-rays to create detailed images of your bones, blood vessels, and soft tissues.
  • Echocardiograms: These check the heart function and look for fluid buildup, which could be a sign of mesothelioma.
  • Magnetic resonance imaging (MRI) scans: These create detailed images of the structures inside your body using large magnets, radio waves, and computers.
  • Positron emission tomography (PET) scans: These use radioactive substances called radiotracers to measure changes in the metabolic or biochemical function of your tissues.
  • X-rays: These use safe amounts of radiation to take pictures of bones and soft tissues.

Finally, if doctors believe you may have mesothelioma after these tests, they’ll order a biopsy. This allows doctors to remove a small sample of fluid and tissue and look at it under a microscope for cancer cells. A biopsy will ultimately confirm if you have sarcomatoid mesothelioma or not.

Misdiagnosis of Sarcomatoid Mesothelioma

Doctors may misdiagnose this cancer because the cancer shares symptoms with many other health problems.

Sarcomatoid mesothelioma can be misdiagnosed as:

  • Benign fibrous tumors
  • Fibrous pleuritis or pleurisy
  • Kidney cancer
  • Lung cancer
  • Non-Hodgkin’s lymphoma
  • Synovial sarcoma (soft tissue cancer)
  • Other cancerous tumors

A sarcomatoid malignant mesothelioma misdiagnosis can be very dangerous, as you could receive treatment for the wrong health problem — and your cancer could worsen in the meantime.

To avoid getting misdiagnosed, seek a second opinion from a mesothelioma specialist.

Subtypes of Sarcomatoid Mesothelioma

There are several subtypes of this cancer. Which subtype a patient has depends on the features of the cells that make up their cancer tumors.

These subtypes include:

  • Desmoplastic mesothelioma: This subtype accounts for 21% of sarcomatoid mesothelioma cases. Patients with this cell type have a median life expectancy of 6.2 months after diagnosis. Tumors with this cell type may be hard to diagnose as they often contain both cancerous and benign (noncancerous) tissue.
  • Lymphohistiocytoid mesothelioma: This was once considered a subtype of sarcomatoid mesothelioma, but is now thought to be an epithelial subtype. Patients with this type tend to live just as long as those with epithelial mesothelioma. Doctors often mistake these cells for lymphoma or tumors that begin in the lymph system.
  • Osteosarcomatous/chondrosarcomatous mesothelioma: This subtype makes up 2% of all cases. These malignant cells have nuclei of various shapes and sizes.
  • Transitional mesothelioma: These cells don’t look like sarcomatoid cells or epithelial cells under a microscope. However, patients with transitional mesothelioma tend to have lifespans similar to patients with other sarcomatoid mesothelioma subtypes. These cells grow in sheets and are plump, according to the Journal of Thoracic Oncology.

Roughly 44% of sarcomatoid cases won’t fall under one of these subtypes, according to the medical journal Modern Pathology.

Mesothelioma doctors can confirm that a patient has sarcomatoid mesothelioma — and take note of any subtype that is present — using a biopsy.

Learn more about different mesothelioma types in our Free Mesothelioma Guide.

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Prognosis for Sarcomatoid Mesothelioma

The prognosis or expected outcome for mesothelioma is poor, and sarcomatoid patients have the worst prognosis. Doctors tend to measure mesothelioma prognosis using life expectancy figures and survival rates.

That said, it may be possible for patients to outlive these averages and become long-term survivors. Despite how aggressive this cell type is, treatment for sarcomatoid mesothelioma is still available to help improve survival times.

Sarcomatoid Mesothelioma Treatments

Getting mesothelioma treatments is the best way to live longer following a sarcomatoid diagnosis. Learn about the best treatments for mesothelioma of the sarcomatoid type below.


Surgery is when a doctor removes sarcomatoid mesothelioma tumors along with nearby healthy tissue. Those with early-stage sarcomatoid mesothelioma may qualify for surgeries that can help them live longer.

Surgeries used for early-stage mesothelioma include:

  • Cytoreduction with HIPEC: This is used to treat peritoneal mesothelioma and involves surgically removing cancer tissue from the abdominal lining (peritoneum), then using liquid chemotherapy to kill leftover cancer cells.
  • Extrapleural pneumonectomy: This is used to treat pleural mesothelioma and involves removing the diseased lung, the lung lining (pleura), part of the diaphragm, and part of the heart lining (pericardium).
  • Pleurectomy with decortication: Also used to help pleural mesothelioma patients, doctors remove the pleura and cancer tumors from the lungs and chest wall.

Patients with stage 1 or 2 sarcomatoid pleural mesothelioma that underwent surgery lived for over 7.5 months on average in a 2019 study.

Clinical guidelines do not usually recommend surgery for mesothelioma if the patient is in a later stage. However, palliative (pain-relieving) surgeries may improve late-stage patients’ quality of life.


Chemotherapy involves using anti-cancer drugs to reduce signs and symptoms of cancer. Sarcomatoid mesothelioma (and other types of this cancer) are typically treated using a combination of two chemotherapy drugs: cisplatin and pemetrexed.

A 2021 study found that sarcomatoid pleural mesothelioma patients treated with chemotherapy lived for 10.7 months on average.

Radiation Therapy

Radiation therapy uses X-rays and other energy beams to treat sarcomatoid mesothelioma tumors and prevent them from spreading.

Providers usually use radiation therapy as part of a multimodal treatment approach (where two or more therapies are used to fight cancer).

Clinical Trials

Some sarcomatoid mesothelioma patients may turn to clinical trials for help if their cancer doesn’t respond to the treatments listed above.

Test vials in a lab

Mesothelioma clinical trials study new and possibly better treatments that can help patients. Some clinical trials are looking for ways to assist sarcomatoid mesothelioma patients specifically.

Call (888) 360-2406 to learn more about your sarcomatoid mesothelioma treatment options after a diagnosis.

Help for Sarcomatoid Mesothelioma Patients & Loved Ones

Receiving a sarcomatoid mesothelioma diagnosis can be traumatizing and stressful for the whole family.

Fortunately, we at Mesothelioma Resource Group are here to help you and your loved ones. We can connect you with mesothelioma specialists, top treatments, and financial aid.

Download our Free Mesothelioma Guide now to learn more about how we can assist you.

Sarcomatoid Mesothelioma FAQs

Where can sarcomatoid mesothelioma develop?

Most cases of sarcomatoid mesothelioma are found in cases of malignant pleural mesothelioma, which means they develop in the lining of the lungs.

In rare instances, sarcomatoid mesothelioma tumors can develop in the abdominal lining, heart lining, and testicle lining too.

Asbestos exposure is the only known cause of any type of mesothelioma, including sarcomatoid. Asbestos damages cells in the mesothelium, your body’s internal lining. This leads to DNA damage, which triggers cellular mutations and cancer.

It typically takes 10-50 years for someone to develop any type of mesothelioma after exposure to asbestos.

No. There is no known cure for any type of mesothelioma, but early diagnosis and treatments like chemotherapy and radiation therapy can extend your life expectancy.

Very few sarcomatoid patients go into remission. However, mesothelioma remission may be possible if you get medical treatment.

Talk to a mesothelioma doctor to learn if your cancer could enter remission.

Mesothelioma Symptoms was founded by a team of advocates to educate people about this aggressive form of cancer. Mesothelioma affects thousands of people each year. We help give hope to those impacted by mesothelioma.

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  2. American Journal of Clinical Pathology. (1998). “The diagnosis of desmoplastic malignant mesothelioma and its distinction from fibrous pleurisy: a histologic and immunohistochemical analysis of 31 cases including p53 immunostaining.” Retrieved March 2, 2023, from

  3. Asthma + Lung UK (2020 November). “Mesothelioma.” Retrieved March 2, 2023, from

  4. Cancer Research UK (2021 May 21). “Stages of mesothelioma.” Retrieved March 2, 2023 from

  5. Cedres, S. et. al. (2019 July 9). “Ecacy of Chemotherapy for Malignant Pleural Mesothelioma According to Histology.” Retrieved March 2, 2023, from

  6. Cleveland Clinic (2022 August 3). “Peritoneal Mesothelioma”. Retrieved March 2, 2023, from

  7. HHS Public Access. (2014). “Systematic review of response rates of sarcomatoid malignant pleural mesotheliomas and clinical trials.” Retrieved March 2, 2023, from

  8. Internal Medicine. (2016). “Sarcomatoid Type Primary Pericardial Mesothelioma with a Long-term Survival after the Onset of Cardiac Tamponade.” Retrieved March 2, 2023, from

  9. Journal of Clinical Oncology. (2017). “Phase 1 Dose-Escalation Study of Pegylated Arginine Deiminase, Cisplatin, and Pemetrexed in Patients With Argininosuccinate Synthetase 1–Deficient Thoracic Cancers.” Retrieved March 2, 2023, from

  10. Journal of Surgical Case Reports. (2022). “Sarcomatoid mesothelioma: unusual findings and literature review.” Retrieved March 2, 2023, from

  11. Journal of Thoracic Disease (2016 June 1). “Localized malignant pleural sarcomatoid mesothelioma misdiagnosed as benign localized fibrous tumor.” Retrieved March 2, 2023, from

  12. Kim, S. et. al. (2018 September 29). “Is There a Role for Cancer-Directed Surgery in Early-Stage Sarcomatoid or Biphasic Mesothelioma?” Retrieved March 2, 2023, from

  13. Matsubara, T. et. al. (2017 December). “A Case of the Resected Lymphohistiocytoid Mesothelioma: BAP1 Is a Key of Accurate Diagnosis.” Retrieved March 2, 2023, from

  14. Mayo Clinic (2021 August 10). “Positron emission tomography scan.” Retrieved March 2, 2023, from

  15. Modern Pathology. (2010). “Sarcomatoid mesothelioma: a clinical–pathologic correlation of 326 cases.” Retrieved March 2, 2023, from

  16. National Cancer Institute (2020 October 26). “Radiopharmaceuticals: Radiation Therapy Enters the Molecular Age.” Retrieved March 2, 2023, from

  17. Penn Medicine: Abramson Cancer Center. “Types of Mesothelioma or Pleural Disease.” Retrieved March 2, 2023, from

  18. Salle. F. et. al. (2020 June) “Comprehensive Molecular and Pathologic Evaluation of Transitional Mesothelioma Assisted by Deep Learning Approach: A Multi-Institutional Study of the International Mesothelioma Panel from the MESOPATH Reference Center.” Retrieved March 2. 2023, from

  19. Ultrastructural Pathology. (1988) “Lymphoestioid Mesothelioma: A Rare Lymphomatoid Variance of Predominantly Sarcomatoid Mesothelioma.” Retrieved March 2, 2023, from

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