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Current Treatment Options in Oncology Oct 2001This paper summarizes the author's thoughts about the use of cytoreductive surgery combined with intraperitoneal hyperthermic chemotherapy (CS-IPHC) for treatment of... (Review)
Review
This paper summarizes the author's thoughts about the use of cytoreductive surgery combined with intraperitoneal hyperthermic chemotherapy (CS-IPHC) for treatment of peritoneal malignant mesothelioma. Pleural malignant mesotheliomas are by far more common (about ten- to thirty-fold) than the peritoneal variants (2.2 cases per 1 million in the US). Other locations (pericardium, tunica vaginalis) are very rare. It is well known that chemotherapy for mesothelioma is largely unsatisfactory, and measurement of treatment responses can be difficult. Single agent responses are all less than 20% with currently available agents for systemically administered drugs. Multiple drug combinations are typically more toxic, and have yielded little consistent demonstrable benefit with major studies reporting median survivals consistently under a year. There is currently more attention being paid to the response category of "stable" or absence of disease progression in concert with quality of life measurements; all regimens show poor durability. With peritoneal malignant mesothelioma, malignant ascites is a common presentation and a major factor in disease-related morbidity and mortality. Interperitoneal administration of agents is attractive, but drug distribution is an issue, as are response rates and durability. Multiple treatments are required; further, all neoplasms with peritoneal dissemination are typically understaged by current radiologic tests (CT, MRI), and the variable uptake of sugar by the small bowel limits the use of positron-emission tomography (PET) imaging for peritoneal malignant mesothelioma. Also, symptoms of bowel obstruction are not uncommon, and any mechanical component of obstruction will not improve with any form of chemotherapy. The author's approach relies on surgery to achieve the following: 1) accurate staging; 2) tumor debulking, as possible, and treatment of mechanical obstruction as well as prevention of impending obstruction by resection or bypass; and 3) preparation for the use of intra-operative hyperthermic chemotherapy perfusion. This approach has been associated with rapid clinical symptom improvement, as well as a reliable and durable resolution of ascites with a single therapy. Morbidity and mortality have been acceptable with about 27-month median survival. The inability to provide effective systemic therapy to maintain or consolidate these gains is problematic.
Topics: Antineoplastic Combined Chemotherapy Protocols; Ascites; Combined Modality Therapy; Diagnostic Imaging; Digestive System Surgical Procedures; Epidemiologic Methods; Humans; Hyperthermia, Induced; Infusions, Parenteral; Intestinal Obstruction; Mesothelioma; Peritoneal Neoplasms; Remission Induction; Survival Analysis; Treatment Outcome
PubMed: 12057102
DOI: 10.1007/s11864-001-0044-2 -
Interactive Cardiovascular and Thoracic... Feb 2022Localized malignant mesothelioma is rare. It has a histological pattern identical to diffuse malignant mesothelioma but without diffuse serosal spread. Localized...
Localized malignant mesothelioma is rare. It has a histological pattern identical to diffuse malignant mesothelioma but without diffuse serosal spread. Localized malignant mesothelioma typically originates from the pleura, peritoneum or pericardium, but can occasionally develop from organs. Our cases represent what might be the largest mediastinal localized malignant mesothelioma described and the first presentation of the epithelioid type in the stomach of an adult.
Topics: Adult; Humans; Mediastinum; Mesothelioma; Mesothelioma, Malignant; Pleura; Pleural Neoplasms; Stomach
PubMed: 34586396
DOI: 10.1093/icvts/ivab276 -
Internal Medicine (Tokyo, Japan) 2013
Topics: Adult; Biopsy, Needle; Diagnostic Imaging; Disease Progression; Echocardiography, Doppler; Fatal Outcome; Heart Neoplasms; Humans; Immunohistochemistry; Male; Mesothelioma; Pericardium; Positron-Emission Tomography; Rare Diseases; Sarcoma; Tomography, X-Ray Computed
PubMed: 23291695
DOI: 10.2169/internalmedicine.52.8934 -
Texas Heart Institute Journal Nov 2022This report describes a 76-year-old man with diabetes mellitus who developed coronary artery stenosis from infiltration of a primary malignant pericardial mesothelioma....
This report describes a 76-year-old man with diabetes mellitus who developed coronary artery stenosis from infiltration of a primary malignant pericardial mesothelioma. Three months before referral to the treating hospital, elevated liver function values and cardiac enzymes led to echocardiography, which revealed a motion abnormality in the anterior wall of the heart. The patient was diagnosed with congestive heart failure and admitted to the hospital, where chest computed tomography showed a tumor above the left atrial appendage that compressed the origin of the left anterior descending artery. He was referred to the treating hospital for surgery. Minimally invasive direct coronary artery bypass grafting was performed, but the mass was not resected because of its infiltrating nature and the potential for medical complications. Histologic examination of a biopsy specimen confirmed a primary malignant pericardial mesothelioma. The bypass procedure resolved the coronary artery stenosis caused by the tumor. Although the optimal treatment for primary malignant pericardial mesothelioma is controversial, minimally invasive methods, such as minimally invasive direct coronary artery bypass grafting, may be used successfully.
Topics: Male; Humans; Aged; Minimally Invasive Surgical Procedures; Coronary Stenosis; Heart Neoplasms; Echocardiography; Mesothelioma
PubMed: 36350290
DOI: 10.14503/THIJ-20-7456 -
Journal of Nuclear Cardiology :... Dec 2022
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Mesothelioma, Malignant; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 34228336
DOI: 10.1007/s12350-021-02690-y -
BMJ Case Reports May 2017
Topics: Aged; Disease Progression; Environmental Exposure; Female; Heart Diseases; Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Pericardial Effusion; Pericardium; Rare Diseases
PubMed: 28500034
DOI: 10.1136/bcr-2017-219949 -
Indian Journal of Pathology &... 2018Pericardial mesotheliomas are rare tumors which often present with features of constrictive pericarditis. We present clinical, imaging, histological, and...
Pericardial mesotheliomas are rare tumors which often present with features of constrictive pericarditis. We present clinical, imaging, histological, and immunohistochemical findings of three cases presenting with chronic constrictive pericarditis. Two of these cases were initially treated as tuberculous pericarditis. Histologically, all the three cases were of an epithelioid type and showed positivity for more than one mesothelial markers. Two patients had a fatal outcome, and one was lost to follow-up.
Topics: Adult; Chronic Disease; Female; Heart Neoplasms; Humans; Male; Mesothelioma; Middle Aged; Pericarditis, Constrictive; Pericardium
PubMed: 30303153
DOI: 10.4103/IJPM.IJPM_711_17 -
Arkhiv Patologii 1988
Topics: Female; Heart Neoplasms; Humans; Mesothelioma; Middle Aged; Pericardium
PubMed: 3408372
DOI: No ID Found -
Vrachebnoe Delo Dec 1975
Topics: Heart Neoplasms; Humans; Male; Mesothelioma; Middle Aged; Pericardium
PubMed: 1231268
DOI: No ID Found -
Klinicheskaia Meditsina Jan 1991
Topics: Aged; Diagnosis, Differential; Diagnostic Errors; Heart Neoplasms; Humans; Lung Neoplasms; Male; Mesothelioma; Myocarditis; Pericardium; Pneumonia
PubMed: 2023382
DOI: No ID Found