Lam Anthony R, Bazzi Khalil, Valle Sarah J, Morris David L
Department of Surgery, Peritonectomy Unit, St George Hospital, Kogarah, New South Wales, Australia.
University of New South Wales, St George Hospital Clinical School, Sydney, New South Wales, Australia.
Case Rep Oncol. 2021 Mar 31;14(1):628-633. doi: 10.1159/000514273. eCollection 2021 Jan-Apr.
Pseudomyxoma peritonei (PMP) is a rare mucinous disease most commonly arising from the appendix. Pleural involvement arising from established PMP is seen in a small number of cases. Combined cytoreductive surgery and hyperthermic intrathoracic chemotherapy is the treatment of choice when managing intra-thoracic PMP. In cases of recurrence, surgical intervention may be technically challenging and carry higher rates of complications, morbidity, and mortality. Bromelain and acetylcysteine (BromAc) is a novel treatment modality that has demonstrated mucolytic properties. When injected directly into mucinous disease, it facilitates tumour dissolution and allows it to be aspirated. It has recently been tested in the treatment of inoperable peritoneal mucinous disease, with an acceptable safety profile and positive objective response. Here we describe the first two cases of BromAc administered directly into pleural adenomucinosis, with striking differences in response between the two patients likely due to differences in tumour hardness.
腹膜假黏液瘤（PMP）是一种罕见的黏液性疾病，最常见于阑尾。少数情况下，已确诊的PMP会累及胸膜。对于胸腔内PMP的治疗，联合细胞减灭术和胸腔内热化疗是首选治疗方法。在复发的情况下，手术干预在技术上可能具有挑战性，并且并发症、发病率和死亡率较高。菠萝蛋白酶和乙酰半胱氨酸（BromAc）是一种新型治疗方式，已证明具有黏液溶解特性。直接注射到黏液性疾病中时，它有助于肿瘤溶解并使其能够被吸出。最近它已在无法手术的腹膜黏液性疾病治疗中进行了测试，具有可接受的安全性和积极的客观反应。在此，我们描述了首例直接向胸膜腺黏液瘤注射BromAc的两例病例，两名患者的反应存在显著差异，这可能是由于肿瘤硬度不同所致。
