Ong Mingjing Nicole, Asamu Abdul Samad, Pace Keith, Bugeja Simon
Department of Surgery, Mater Dei Hospital, Msida, Malta.
Department of Urology, Mater Dei Hospital, Msida, Malta.
J Surg Case Rep. 2021 Sep 15;2021(9):rjab392. doi: 10.1093/jscr/rjab392. eCollection 2021 Sep.
We present the case of a 66-year-old male with a history of iatrogenic bladder injury and radiation therapy for colon adenocarcinoma 20 years prior. A computed tomography of the thorax, abdomen and pelvis, reported a presacral mass with invasion to the bladder, ureters and lymph nodes. An initial bladder biopsy was histologically inconclusive. A later biopsy taken during emergency bypass surgery for small bowel obstruction, while the patient was positive for coronavirus disease of 2019, concluded that the mass was a peritoneal mesothelioma of epithelioid origin. The combination management of cytoreductive surgery with intraperitoneal chemotherapy has been a near universal standard of care for epithelioid peritoneal mesothelioma provided that the patient is an appropriate candidate for surgical interventions. To the best of our knowledge, this is the first case report of malignant peritoneal mesothelioma as a second primary carcinoma, many years after exposure to radiation therapy for colon adenocarcinoma.
我们报告了一例66岁男性病例，该患者有医源性膀胱损伤病史，20年前因结肠腺癌接受过放射治疗。胸部、腹部和骨盆的计算机断层扫描显示，骶前有一肿块，侵犯膀胱、输尿管和淋巴结。最初的膀胱活检在组织学上未能得出明确结论。后来在患者因小肠梗阻进行紧急搭桥手术时（当时该患者新型冠状病毒病检测呈阳性）所取的活检结果显示，该肿块为上皮样来源的腹膜间皮瘤。对于上皮样腹膜间皮瘤，只要患者适合手术干预，减瘤手术联合腹腔内化疗的综合治疗一直是几乎通用的标准治疗方法。据我们所知，这是首例在因结肠腺癌接受放射治疗多年后，恶性腹膜间皮瘤作为第二原发性癌的病例报告。
