EDITING: re: anybody know the treatment plan for pleural sarcoma

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</div>Joseph, hi, I am not a doctor - my son has multiple lung mets from his ASPS sarcoma and it is my life for the last 5 years since he was Dx so I read a lot when we go trough the surgeries or pleural effusions so I can explain to you some of it.The dissemination inside of the pleural space is not the metastasis, but the most likely the result of the malignant pleural effusion when the thin walls of the primary tumor were torn and the content spilled inside of the pleural space - the space in between the lung and the shell that surrounds it - pleura. Now it seems that the spilled sarcoma cells have implanted in the inside pleura surface and may be outside lung surface. When tumor cells are seeded they do not necessarily start to grow right away, some of them may start earlier and some stay dormant. But it is not the metastatic stage 4 - it is still stage 3 with the locally advanced disease and generally you are right that the surgery is the main treatment for it. This is a dilemma with the primary lung/pleura sarcomas that the main treatment for it would have been a clean resection which for you case is an extrapleural pneumonectomy - this is a very big surgery, with significant morbidity when people die from the surgery and for many of survivors the possibility of the future metastasis is very high anyways as pleura is a very vascular organ - a lot of blood vessels - and the cells might have already been disseminated distantly by now and just sit dormant. So generally the risk is very high on both ends - surgery/no surgery and it is upto you to pursue the ether avenue. People do live with one lung with the acceptable quality of life. As there is no statistics on it - only single cases - all the recommendations are based on the case by case basis. I do not know why in your case they recommended a chemotherapy - may be just in the attempt to check your chance if your MFH will happen to be a chemosensitive kind and just go away and also they wait to see if more of them will surface. There are some piublications about primary sarcomas of the pleura on the Pubmed.gov and about the pneumonectomy - that you might do a search and to read, I have seen the one from MSK when there were survivors after this surgery: Extrapleural pneumonectomy in children. <a href='http://www.ncbi.nlm.nih.gov/pubmed/17011280'>http://www.ncbi.nlm.nih.gov/pubmed/17011280</a>I wanted to ask if they do an RFA or cryotherapy in Seoul because we have our old member Stan who had RFA for his 4 cm pleural metastasis from his disseminated MFH - and it apparently was successful so you might as well start from it and then to have more other spots ablated and then to see what is happening - I mean that we know that it is disseminated but not all of the implanted seeds survive. How many tumor do they see now in the pleura and what size? 
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