A Risk From Asbestos in Pleurectomy

To the Editor:—  In the preliminary communication of a case report in which pleurectomy was done to stimulate systemic-pulmonary anastomoses to palliate congenital heart disease (194:253, 1965), following pleurectomy, "the surface of the lung was sprinkled with powdered asbestos."In a study of asbestosis and neoplasia Selikoff et al (188:22, 1964) found 45 fatal neoplasms of the lung and pleura, whereas only 6.6 such deaths would have been expected in the total of 255.Four of the tumors were mesiotheliomas, an extremely high incidence for a rare tumor. Smith et al observed pleural adhesions in hamsters in 27 of 37 animals¹ following a single intrapleural injection of suspensions of three types of asbestos fibers. Four massive tumors and one small neoplasm were found, corresponding to the pleural mesotheliomas of man.It would seem quite possible that the patient described stands a reasonable chance of having a mesothelioma