Yoshida Yukiko, Mizugaki Hidenori, Sato Yuma, Kuwahara Ken, Yamada Noriyuki, Asahina Hajime, Yokouchi Hiroshi, Matsuno Yoshihiro, Oizumi Satoshi
Department of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, Japan.
Department of Diagnostic Pathology, NHO Hokkaido Cancer Center, Sapporo, Japan.
Respir Med Case Rep. 2025 Jun 26;56:102242. doi: 10.1016/j.rmcr.2025.102242. eCollection 2025.
An 80-year-old woman presented to our hospital with the chief complaint of left lateral thoracic pain. Chest computed tomography showed multiple nodular lesions in the left pleura and massive left pleural effusion. Based on clinical findings, imaging, and thoracoscopic pleural biopsy, a diagnosis of sarcomatoid diffuse pleural mesothelioma clinical T2N0M0 Stage IB was made. We administered nivolumab plus ipilimumab as first-line treatment, which resulted in significant reduction of pleural lesions and complete resolution of pleural effusion after two courses. No immune-mediated adverse events except fever were observed. Treatment was discontinued after 16 courses, with no disease recurrence for more than 2 years following the initial treatment. This case suggests that nivolumab plus ipilimumab can be an effective treatment option for older adults with pleural mesothelioma who maintain a good performance status.
一名80岁女性因左侧胸痛为主诉前来我院就诊。胸部计算机断层扫描显示左侧胸膜有多个结节性病变及大量左侧胸腔积液。根据临床表现、影像学检查及胸腔镜胸膜活检,诊断为肉瘤样弥漫性胸膜间皮瘤,临床分期为T2N0M0,IB期。我们给予纳武单抗联合伊匹单抗作为一线治疗,两个疗程后胸膜病变显著减少,胸腔积液完全消退。除发热外,未观察到免疫介导的不良事件。16个疗程后停止治疗,初始治疗后2年多无疾病复发。该病例提示,纳武单抗联合伊匹单抗对于身体状况良好的老年胸膜间皮瘤患者可能是一种有效的治疗选择。