First report of pleural mesothelioma treated with cytoreductive surgery and hyperthermic intrathoracic chemotherapy in Kazakhstan: a case report

BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare but aggressive neoplasm arising from the mesothelial lining of the pleura.Despite advancements in systemic chemotherapy and targeted therapies, the prognosis for MPM remains poor, with a median survival of 8-14 months. Standard treatment modalities include surgery in combination with radiotherapy and/or chemotherapy. Hyperthermic Intrathoracic Chemotherapy (HITOC) has emerged as a promising adjunct to surgery. CASE PRESENTATION: A 35-year-old Asian male was diagnosed with Stage II malignant pleural mesothelioma (T2N0M0). The patient underwent systemic chemotherapy consisting of six cycles of pemetrexed, carboplatin, and bevacizumab. The PET-CT demonstrated stabilization of the disease, with no evidence of metabolic activity or tumor growth, suggesting a positive response to chemotherapy.Considering the localized nature of the disease and the absence of significant progression, the patient underwent cytoreductive surgery with Hyperthermic Intrathoracic Chemotherapy (HITOC) as the next step in treatment. CONCLUSION: This case reports first successful application of HITOC for patient with MPM in Kazakhstan. It underscores the practical considerations, safety profile, and outcomes, contributing to the growing body of evidence supporting this approach.