Malignant peritoneal mesothelioma (MPeM) is a highly malignant neoplasm of the peritoneum, which carries a poor prognosis. A 70-year-old man, who was employed in the shipbuilding industry and exposed to asbestos for 50 years, was found to have a low-density lesion in the peritoneum around the liver and spleen, associated with multiple mediastinal and parasternal lymphadenopathy. Laparoscopic exploration was performed, and biopsy specimen analysis led to a diagnosis of MPeM. Initial systemic chemotherapy comprising cisplatin and pemetrexed yielded a modest cytoreductive effect. However, 4 months later, the patient presented with abdominal distension and anorexia. CT images revealed massive ascites, bowel obstruction and an enlarged intra-abdominal tumour, which was considered progression of the MPeM. The patient was treated with nivolumab. Bowel obstruction was improved after the first administration, and his sense of abdomen distension completely disappeared after the third administration. This case supports the utility of immunotherapy in MPeM.
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Contributors TT, YM and AS contributed to conception and design, acquisition of data or analysis, interpretation of data and drafting of the article. NF contributed to drafting of the article and gave a final approval of the version published.
Funding The Ministry of Health, Labor and Welfare, Japan grant number (180101-02).
Competing interests NF reports consultancy from Kyorin, ONO, Bristol-Meyers Squib and Boehringer Ingelheim, and honoraria from Ono, Daiichi Sankyo, Eli Lilly, Hisamitsu Pharm, Chugai Pharm, Bristol-Meyers Squib and Astellas Pharma. All other authors declare no competing interest.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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