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Orthotopic Implantation and Peripheral Immune Cell Monitoring in the II-45 Syngeneic Rat Mesothelioma Model
Published on: October 2, 2015
Malignant peritoneal mesothelioma
Kamal E Bani-Hani1, Kamal A Gharaibeh
1Department of Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. banihani60@yahoo.com
Background And Objectives:
The incidence of malignant peritoneal mesothelioma (MPM) is rising. Our aim was to present our experience with this entity in order to increase the awareness about this disease to avoid misdiagnosis.
Methods:
Records of seven patients with histologically confirmed MPM were retrospectively reviewed. Demographic and clinicopathological findings were studied in detail.
Results:
There were two females and 5 males; mean age was 50.3 years (range 16-73). Asbestos exposure was recorded in two patients, familial Mediterranean fever in one and previous radiation in one. Main presentations were abdominal pain and distension. None of the patients was diagnosed preoperatively. The average delay in diagnosis was 10 months. Calretinin expression was identified in all tumors. Three patients were treated with cytoreductive surgery combined with systemic chemotherapy. Two patients who remain alive were young female patients who were diagnosed by laparoscopic incidental findings and were treated with cytoreductive surgery combined with hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). Median survival was 19.7 months. The average survival time of the five patients who died of their diseases was 10.2 months.
Conclusions:
An awareness of MPM is important to prevent misdiagnosis. Immunohistochemistry has an important role in confirming the diagnosis. MPM remains a difficult therapeutic challenge. Thorough cytoreductive surgery is the cornerstone of current treatment while HIIC is a promising strategy in suitable patients.
Insights
Malignant peritoneal mesothelioma (MPM) is often misdiagnosed, highlighting the need for increased awareness. Cytoreductive surgery with hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) shows promise for improving outcomes in select MPM patients.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Malignant peritoneal mesothelioma (MPM) incidence is increasing.
- Early misdiagnosis is common, necessitating greater disease awareness.
Purpose of the Study:
- To present clinical experience with MPM to improve diagnostic accuracy.
- To highlight key diagnostic and therapeutic challenges.
Main Methods:
- Retrospective review of seven histologically confirmed MPM cases.
- Detailed analysis of demographic and clinicopathological data.
- Immunohistochemistry for calretinin expression.
Main Results:
- No preoperative diagnoses were made; average diagnostic delay was 10 months.
- Calretinin expression confirmed MPM in all cases.
- Two survivors received cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIIC); median survival was 19.7 months.
Conclusions:
- Increased awareness and prompt diagnosis are crucial for managing MPM.
- Immunohistochemistry is vital for accurate MPM diagnosis.
- Cytoreductive surgery is the mainstay of treatment, with HIIC offering a promising therapeutic strategy.
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