Mesothelioma is primarily a disease of adults and usually presents in the fifth to seventh decades, and 70-80% of cases occur in men. Those diagnosed between the ages of 20 to 40 years usually have a history of childhood exposure [1] . Typical presenting features are those of chest pain, dyspnoea or both [11, 21] , and in one series up to a third of patients presented with breathlessness due to a pleural effusion without chest pain [22] . When it occurs, the chest pain tends to be dull or boring in nature, but a pleuritic-type pain can occur in the presence of pleural effusions. Involvement of the mediastinal structures is well recognized but hoarseness of the voice and superior vena caval obstruction only rarely causes major symptoms. Dysphagia can also occur but this is a late finding. Unlike bronchogenic carcinomas, presentation with haemoptysis, lymphadenopathy and metastatic symptoms are unusual. A chest wall mass, weight loss and sweating are less common presentations, as is peritoneal mesothelioma although involvement may be found in up to one third of cases at autopsy. Presentation of peritoneal mesothelioma is with non-specific symptoms including loss of appetite, nausea and vomiting, diarrhoea or constipation and occasionally ascites. Small bowel obstruction is usually a late feature, and overall the prognosis of peritoneal mesothelioma is worse than pleural mesothelioma with a mean survival time of about 7 months [11] .