Rare but aggressive malignancy of the mesothelial tissue (serosal membrane) of the pleura (most frequent type), peritoneum, pericardium, and tunica vaginalis, commonly associated with long-term occupational exposure to asbestos (see also asbestosis). Onset is gradual, typically years after exposure. Few symptoms manifest until advanced stages, unless discovered inadvertently during chest imaging. Characterized by chest pain, cough, dyspnea, anorexia, and fatigue. Other common signs and symptoms include abdominal pain, ascites, nail clubbing, and abdominal distension. Risk of lung cancer is greatly increased in smokers exposed to asbestos.

Management for stages I and II is typically surgical resection, followed by adjuvant therapy, radiation therapy, and/or chemotherapy. Treatment of nonsurgical candidates includes radiation therapy or combined modality therapy (chemotherapy and thoracic irradiation).