Clinicopathological characteristics of primary peritoneal epithelioid mesothelioma of clear cell type
| Autor: | Ying Gao, Jian-Mei Zhang, Xue-Mei Du, Ya-Ping Wei, Hong Chang, Yan Li, Zhao Li |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Antineoplastic Agents Docetaxel Hyperthermic Intraperitoneal Chemotherapy Pemetrexed Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Exome Sequencing Humans Medicine Hepatic artery embolization 030212 general & internal medicine Mesothelioma Peritoneal Neoplasms Aged Chemotherapy business.industry Mesothelioma Malignant Cytoreduction Surgical Procedures General Medicine Swollen lymph nodes medicine.disease Embolization Therapeutic Immunohistochemistry Treatment Outcome Von Hippel-Lindau Tumor Suppressor Protein 030220 oncology & carcinogenesis Hyperthermic intraperitoneal chemotherapy Cisplatin medicine.symptom Tomography X-Ray Computed business Clear cell medicine.drug |
| Zdroj: | Medicine. 100:e25264 |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Rationale Primary peritoneal epithelioid mesothelioma of clear cell type is an extremely rare entity composed of clear cytoplasm. It is challenging to diagnose because of the morphological resemblance to clear cell tumor. Patients concerns A 69-year-old male patient had swollen lymph nodes in the right inguinal region for 7 months and was constipated for 1 month. Diagnosis The patient was diagnosed as peritoneal epithelioid mesothelioma of clear cell type based on computed tomography scan, pathology, immunohistochemistry, special staining and whole-exome sequencing. This patient harbored VHL gene alteration in exon 1 and homologous recombination defect (with a score of 45). This finding indicated that this patient might be sensitive to platinum-based therapy and Poly ADP-ribose Polymerase (PARP) inhibitor. This patient carried no microsatellite instability, a low level of tumor mutation burden, and a high extent of intratumoral heterogeneity. Eighteen neoantigens were detected. Interventions The patient received surgery-based multidisciplinary treatment by integrating cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC was administered with docetaxel 120 mg plus cisplatin 120 mg, at 43°C, for 60 minutes. After operation, the patient received intravenous (IV) chemotherapy with docetaxel 60 mg, pemetrexed 750 mg and cisplatin 100 mg, and then intraperitoneal (IP) chemotherapy with docetaxel 40 mg. The patient received interventional therapy of hepatic artery embolization for 5 times. Outcomes Regular follow-up was performed until Oct 14, 2020. The patient died 31.6 months later owing to incomplete intestinal obstruction. Lessons Primary peritoneal epithelioid mesothelioma of clear cell type needs to be differentiated from a variety of clear cell tumors. This disease is characterized by specific genetic alteration. Whole-exome sequencing contributes to guide individualized therapy. CRS-HIPEC helps achieve long-term overall survival. |
| Databáze: | OpenAIRE |
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