Abstract
Malignant pleural mesothelioma (MPM) is a rare disease causing chest pain and dyspnea when the tumor invades the pleura, and pleural effusion. MPM frequently compromises activity levels (particularly in the elderly) unless radically treated. The Japanese guidelines state that the definitive therapy is trimodal (extrapleural pneumonectomy [EPP], systemic chemotherapy, and hemithoracic irradiation). However, EPP is highly invasive, and postoperative complications may develop in the elderly. Recent studies have shown that pleurectomy/decortication (P/D) (lung-preserving radical surgery) affords outcomes similar to EPP. We performed P/D to treat MPM in an octogenarian with intractable pleural effusion. The surgical procedure was completed in 440 min, with hemorrhage of 2,095g. The postoperative pathological diagnosis was biphasic MPM. No major postoperative complication developed, and the patient was discharged 14 days after surgery. The patient survives without pleural effusion more than 2 months after discharge.
