Malignant Peritoneal Mesothelioma: Report of 2 Cases

Yuichi Kasakura, Masashi Fujii, Fumirou Mochizuki, Takerou Mazaki, Shigetomi Iwai and Tsutomu Yamada^<*

3rd Department of Surgery, Nihon University School of Medicine

^*Department of pathology, Nihon University School of Medicine

We experienced two patients with malignant peritoneal mesothelioma. Both patients had a history of exposure to asbestos; one had been given a diagnosis of asbestosis. Both patients showed ascites retention; they complained of abdominal flatulence and abdominalgia, and the ascitic fluids appeared bright yellow and viscous in nature. Cytological examination, suggested mesothelioma. The preoperative diagnosis was considered difficult because of the importance of differentiating from the diseases which cause ascites, particularly cancerous peritonitis. Accordingly, exclusion diagnosis by dissection of the celiac viscera was necessary. In both cases, mesothelioma was classified as diffuse clinically and as epithelial histologically, and special stainings exhibited positive for malignant peritoneal mesothelioma by hyaluronidase digestion method. One patient had constriction in the ileum. Another showed no response to thermotherapy; therefore celiotomy was performed to administer the antitumor drugs, but the treatment was palliative. The antitumor drugs cisplatine and etoposide were used and they were effective in reducing the volume of ascites. However, at present, no effective therapy is available to treat mesothelioma. As its prognosis is significantly poor, a new multidisciplinary therapy were including gene therapy and immunotherapy should be searched for.

Key words
malignant peritoneal mesothelioma

Reprint requests
Yuichi Kasakura 3rd Department of Surgery, Nihon University School of Medicine 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173 JAPAN

Accepted
September 22, 1999

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