Bairos Menezes Maria, Pedroso de Lima Rita, Dunões Inês, Inácio Mariana, Dinis Rui
Medical Oncology, Hospital Espírito Santo de Évora, Évora, PRT.
Surgery, Hospital Espírito Santo de Évora, Évora, PRT.
Cureus. 2024 Jan 22;16(1):e52716. doi: 10.7759/cureus.52716. eCollection 2024 Jan.
Malignant peritoneal mesothelioma (MPeM) is a rare cancer of the peritoneum with a poor prognosis and nonspecific clinical course. We discuss a case of MPeM in a 59-year-old male who presented with abdominal pain and distension, without any known previous asbestos exposure. The diagnosis was made after a second biopsy finally confirmed epithelioid MPeM in an advanced stage with pleural effusion. The patient underwent six cycles of chemotherapy with cisplatin and pemetrexed, experienced disease progression, and was then started on pembrolizumab as a second-line treatment. The patient achieved a complete response after two years of treatment with pembrolizumab and has been disease-free for almost four years with an Eastern Cooperative Oncology Group (ECOG) performance status of 0. Despite the lack of evidence to support the treatment with immunotherapy for MPeM, our case report encourages its use, highlighting its ability to enable a complete response with pembrolizumab with an excellent quality of life.
恶性腹膜间皮瘤（MPeM）是一种罕见的腹膜癌，预后较差，临床过程不具特异性。我们讨论一例59岁男性的MPeM病例，该患者表现为腹痛和腹胀，既往无已知石棉接触史。在第二次活检最终确诊为晚期上皮样MPeM伴胸腔积液后，做出了诊断。患者接受了六个周期的顺铂和培美曲塞化疗，病情进展，随后开始使用帕博利珠单抗作为二线治疗。患者在接受帕博利珠单抗治疗两年后获得完全缓解，目前已无病生存近四年，东部肿瘤协作组（ECOG）体能状态为0。尽管缺乏支持MPeM免疫治疗的证据，但我们的病例报告鼓励使用免疫治疗，强调其使用帕博利珠单抗实现完全缓解并具有优异生活质量的能力。
