Malignant peritoneal mesothelioma with massive ascites as the first symptom:A case report  

作　　者：Xi Huang Yu Hong Si-Ya Xie Hui-Li Liao Hao-Ming Huang Jian-Hong Liu Wen-Jie Long 

机构地区：[1]Department of Geriatrics,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong Province,China [2]Department of Chinese Internal Medicine,The First Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong Province,China [3]Department of Geriatrics,The First Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong Province,China [4]Department of Emergency,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2022年第28期10317-10325,共9页世界临床病例杂志

基　　金：Supported by the National Traditional Chinese Medicine Clinical Research Base,No.2018131;the Guangzhou Science and Technology Program Key Projects,No.202206080015。

摘　　要：BACKGROUND Malignant peritoneal mesothelioma(MPM) is an extremely rare tumor with nonspecific clinical manifestations,which is extremely difficult to diagnose.Herein,we reported a case of MPM in the abdominal cavity with massive shortterm ascites as the first symptom.CASE SUMMARY A 65-year-old woman presented to the hospital with abdominal pain,distention,and shortness of breath that persisted for 15 d.The serum CA-125 level was 1075 U/m L.The abdominal computed tomography showed massive ascites and no obvious tumor lesions.The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures.The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2(-),WT-1(-),Ki-67(about 10% +),CEA(-),Glut-1(+++),desmin(-),PD-L1(-),and CDKN2A(P16).The final diagnosis was MPM.The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy.In the second cycle,she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites.She died of disease progression 2 mo after diagnosis.CONCLUSION In case of massive unexplained ascites,the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment.

关 键 词：Malignant peritoneal mesothelioma ASCITES IMMUNOHISTOCHEMISTRY CHEMOTHERAPY IMMUNOTHERAPY Case report 

分 类 号：R735.5[医药卫生—肿瘤]