Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review
Background: Malignant mesothelioma (MM) is a tumor originating from the pleura, peritoneum, or pericardial cavity. It is divided into diffuse and localized malignant mesothelioma, with four subtypes in diffuse MM: epithelioid, sarcomatoid, desmoplastic, and biphasic, with biphasic being less common....
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Frontiers Media S.A.
2024-01-01
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| Series: | Pathology and Oncology Research |
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| Online Access: | https://www.por-journal.com/articles/10.3389/pore.2023.1611577/full |
| _version_ | 1797222288263741440 |
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| author | Minying Deng Xinyi Zhang Chen Xu Rongkui Luo Lingli Chen Yuhong Zhou Yingyong Hou |
| author_facet | Minying Deng Xinyi Zhang Chen Xu Rongkui Luo Lingli Chen Yuhong Zhou Yingyong Hou |
| author_sort | Minying Deng |
| collection | DOAJ |
| description | Background: Malignant mesothelioma (MM) is a tumor originating from the pleura, peritoneum, or pericardial cavity. It is divided into diffuse and localized malignant mesothelioma, with four subtypes in diffuse MM: epithelioid, sarcomatoid, desmoplastic, and biphasic, with biphasic being less common. The onset of this tumor is insidious, and the prognosis is extremely poor in some cases, with a median survival of 6–18 months and no standard treatment options in the past.Aims: We report a case of peritoneal malignant mesothelioma that was successfully treated with transformative therapy. We also review the literature in the hope of providing reference for the treatment and pathological diagnosis of such patients.Methods: The case of the peritoneal malignant mesothelioma was processed and reported in the routine manner for biopsy specimens at different stages.Results and conclusion: We report a case of a malignant tumor originating in the hepatorenal recess, which was diagnosed as biphasic malignant mesothelioma through a biopsy. Immunohistochemical testing showed PD-L1 expression. After multidisciplinary discussion, the patient received transformative treatment, including a trial of combined immunotherapy. The tumor significantly shrank, and the patient obtained a chance for curative surgical resection. Microscopic examination showed significant collagenization in the lesion area, with almost no residual tumor. After 19 months of comprehensive treatment, the patient developed multiple fluffy opacities under the pleura of both lungs. Transthoracic core needle biopsy under CT guidance, the pathology showed organizing pneumonia, considering it as delayed interstitial pneumonitis due to immunotherapy based on previous treatment history. Successful comprehensive treatment was achieved for this case of peritoneal malignant mesothelioma, and the patient has been alive without evidence of disease for 33 months, with long-term follow-up. In this process, the pathologist had three opportunities for pathological diagnosis, which required understanding the patient’s medical history, being attentive to the clinical purpose of the specimen, and providing accurate responses to morphological changes at different stages, along with corresponding descriptions and diagnoses to provide effective information for clinical treatment. |
| first_indexed | 2024-04-24T13:18:57Z |
| format | Article |
| id | doaj.art-0f1bc8a3352a4db599aec5f602d0bc4f |
| institution | Directory Open Access Journal |
| issn | 1532-2807 |
| language | English |
| last_indexed | 2024-04-24T13:18:57Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Pathology and Oncology Research |
| spelling | doaj.art-0f1bc8a3352a4db599aec5f602d0bc4f2024-04-04T16:24:31ZengFrontiers Media S.A.Pathology and Oncology Research1532-28072024-01-012910.3389/pore.2023.16115771611577Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature reviewMinying Deng0Xinyi Zhang1Chen Xu2Rongkui Luo3Lingli Chen4Yuhong Zhou5Yingyong Hou6Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Pathology, Zhongshan Hospital, Fudan University, Shanghai, ChinaBackground: Malignant mesothelioma (MM) is a tumor originating from the pleura, peritoneum, or pericardial cavity. It is divided into diffuse and localized malignant mesothelioma, with four subtypes in diffuse MM: epithelioid, sarcomatoid, desmoplastic, and biphasic, with biphasic being less common. The onset of this tumor is insidious, and the prognosis is extremely poor in some cases, with a median survival of 6–18 months and no standard treatment options in the past.Aims: We report a case of peritoneal malignant mesothelioma that was successfully treated with transformative therapy. We also review the literature in the hope of providing reference for the treatment and pathological diagnosis of such patients.Methods: The case of the peritoneal malignant mesothelioma was processed and reported in the routine manner for biopsy specimens at different stages.Results and conclusion: We report a case of a malignant tumor originating in the hepatorenal recess, which was diagnosed as biphasic malignant mesothelioma through a biopsy. Immunohistochemical testing showed PD-L1 expression. After multidisciplinary discussion, the patient received transformative treatment, including a trial of combined immunotherapy. The tumor significantly shrank, and the patient obtained a chance for curative surgical resection. Microscopic examination showed significant collagenization in the lesion area, with almost no residual tumor. After 19 months of comprehensive treatment, the patient developed multiple fluffy opacities under the pleura of both lungs. Transthoracic core needle biopsy under CT guidance, the pathology showed organizing pneumonia, considering it as delayed interstitial pneumonitis due to immunotherapy based on previous treatment history. Successful comprehensive treatment was achieved for this case of peritoneal malignant mesothelioma, and the patient has been alive without evidence of disease for 33 months, with long-term follow-up. In this process, the pathologist had three opportunities for pathological diagnosis, which required understanding the patient’s medical history, being attentive to the clinical purpose of the specimen, and providing accurate responses to morphological changes at different stages, along with corresponding descriptions and diagnoses to provide effective information for clinical treatment.https://www.por-journal.com/articles/10.3389/pore.2023.1611577/fullperitoneal malignant mesotheliomaconversion therapyclinical pathologydelayed interstitial pneumonitisPD-L1 expression |
| spellingShingle | Minying Deng Xinyi Zhang Chen Xu Rongkui Luo Lingli Chen Yuhong Zhou Yingyong Hou Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review Pathology and Oncology Research peritoneal malignant mesothelioma conversion therapy clinical pathology delayed interstitial pneumonitis PD-L1 expression |
| title | Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review |
| title_full | Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review |
| title_fullStr | Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review |
| title_full_unstemmed | Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review |
| title_short | Clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma: a case report and literature review |
| title_sort | clinical and pathological observation of conversion therapy for malignant peritoneal mesothelioma a case report and literature review |
| topic | peritoneal malignant mesothelioma conversion therapy clinical pathology delayed interstitial pneumonitis PD-L1 expression |
| url | https://www.por-journal.com/articles/10.3389/pore.2023.1611577/full |
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