2003 Volume 43 Issue 4 Pages 357-361
Background. No standard treatment for diffuse malignant pleural mesothelioma has yet been established, but various treatments are being attempted. We report a case of diffuse malignant pleural mesothelioma treated by intrathoracic perfusion chemohyperthermia after pleuropneumonectomy. Case. A 62-year-old man with common cold like symptoms visited a clinic in February 1999. Pleural effusion on the left side was pointed out on chest X-ray film, and he was then followed up. In October 1999, he was referred to our hospital due to increased pleural effusion. Thoracoscopic pleural biopsy revealed diffuse malignant pleural mesothelioma. Pleuropneumonectomy with mediastinal lymph node dissection, and combined resection of the diaphragm were performed in January 2000. Histopathological examination of resected specimens showed that tumor cells were located diffusely in the parietal pleura and partly invaded the subpleural fat tissue. Five months after the operation, intrathoracic perfusion chemohyperthermia was performed. After intrathoracic observation using a thoracoscope, intrathoracic perfusion was performed using sa line solution at 42-43°C containing 20 μg ml of CDDP for 60 minutes. The patient had no intraoperative or postoperative complications. For three years after the resection, recurrence was not observed and the patient was followed up as an outpatient. Conclusion. Intrathoracic perfusion chemohyperthermia could be considered as one type of useful adjuvant therapy after surgery to prevent recurrence of diffuse malignant pleural mesothelioma.
