Surgical treatment for pleural mesothelioma with hyperthermic intrathoracic chemotherapy: a clinical case

The purpose of the study: to review the combined surgical treatment of patients with malignant pleural mesothelioma using hyperthermic intrapleural chemoperfusion and provide clinical cases of surgical treatment of mesothelioma. Materials and methods. The article provides an overview of surgical options for pleural mesothelioma using hyperthermic intrapleural chemotherapy. Two successful clinical cases of surgical treatment of pleural mesothelioma in the scope of extrapleural pleuropneumonectomy with diaphragm resection and hyperthermic intrapleural chemotherapy are presented. Results. Malignant mesothelioma is a rare neoplasm that develops from mesothelial cells lining body cavities, including the pleura, pericardium, peritoneum, and tunica vaginalis. The incidence of malignant mesothelioma is heterogeneous in different regions of the world. According to some estimates, 28,000-43,000 people die annually from malignant pleural mesothelioma worldwide. Among all mesothelial tumors, the proportion of pleural mesothelioma is more than 2/3. Etiologically, pleural mesothelioma is more often caused by exposure to asbestos. Thoracoscopic biopsy is the most effective way to obtain material for morphological examination. Pleural mesothelioma includes three histological subtypes: epithelioid, sarcomatoid, and mixed/biphasic. Conclusion. Determining the histological subtype of a tumor is crucial for further treatment and prognosis. Recommended mesothelial markers are calretinin, WT1, D2-40 podoplanin), HBME-1, and CK5/6. The treatment of mesothelioma is a complex task. During surgery for mesothelioma, it is necessary to achieve macroscopic complete resection to improve long-term results.