Long-Term Survival of More than 5 Years with Maintenance Therapy Using Single-Agent Pemetrexed in a Patient with Diffuse Malignant Peritoneal Mesothelioma.

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Case Reports in Medicine Pub Date : 2023-01-01 DOI:10.1155/2023/2092157
Yasuo Otsuka, Yoriaki Komeda, Masayuki Takeda, Takayuki Takahama, Masashi Kono, Mamoru Takenaka, Satoru Hagiwara, Naoshi Nishida, Hiroshi Kashida, Masatoshi Kudo
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引用次数: 1

Abstract

A 76-year-old woman presented with lower abdominal pain and nausea and was referred to the gastroenterology department in our institution. Previous contrast-enhanced computed tomography (CE-CT) for follow-up after breast cancer surgery had indicated a soft tissue mass below the right diaphragm, which was considered a benign change. CE-CT performed at the first visit to our department revealed further thickening of the soft tissue mass with extension to the liver surface. In addition, ascites and nodules were observed in the abdominal cavity. Histopathological examination of a biopsy specimen revealed peritoneal invasion of atypical epithelioid cells with trabecular and glandular patterns. The tumor cells were positive for AE1/AE2, calretinin, WT-1, D2-40, HEG1, EMA, BAP1, and MTAP and negative for carcinoembryonic antigen, MOC-31, Ber-Ep4, ER, PgR, TTF-1, claudin 4, and desmin. A diagnosis of epithelioid mesothelioma was made. The patient received chemotherapy with cisplatin (75 mg/m2) and pemetrexed (500 mg/m2). After six courses of combined chemotherapy, pemetrexed was administered as a single agent. At the time of writing this report, she was undergoing over the 30th course of chemotherapy without any significant side effects. Diffuse malignant peritoneal mesothelioma is a rare, fatal, and progressive disease. Our patient achieved long-term survival of more than 5 years with maintenance therapy using single-agent pemetrexed.

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弥漫性腹膜恶性间皮瘤患者单药培美曲塞维持治疗的长期生存率超过5年。
一位76岁的女性以下腹疼痛和恶心被转介到我们医院的消化内科。先前乳腺癌手术后随访的对比增强计算机断层扫描(CE-CT)显示右侧横膈膜下方有软组织肿块,这被认为是良性改变。首次到我科就诊时进行的CE-CT显示软组织肿块进一步增厚并延伸至肝脏表面。腹腔内见腹水及小结节。活检标本的组织病理学检查显示腹膜浸润的非典型上皮样细胞具有小梁和腺型。肿瘤细胞AE1/AE2、calretinin、WT-1、D2-40、HEG1、EMA、BAP1、MTAP阳性,癌胚抗原、MOC-31、Ber-Ep4、ER、PgR、TTF-1、claudin 4、desmin阴性。诊断为上皮样间皮瘤。患者接受顺铂(75 mg/m2)和培美曲塞(500 mg/m2)化疗。在6个疗程的联合化疗后,培美曲塞作为单药给药。在撰写本报告时,她正在接受超过30个疗程的化疗,没有任何明显的副作用。弥漫性恶性腹膜间皮瘤是一种罕见的、致命的、进行性疾病。我们的患者通过单药培美曲塞维持治疗获得了超过5年的长期生存。
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来源期刊
Case Reports in Medicine
Case Reports in Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
0.00%
发文量
53
审稿时长
13 weeks
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