[A case of malignant peritoneal mesothelioma treated effectively with cisplatin and gemcitabine]

Peritoneal mesothelioma presents difficulty in early diagnosis and establishment of standard treatment. We report a case of malignant peritoneal mesothelioma treated effectively with cisplatin and gemcitabine. A 53-year-old man, presenting with abdominal fullness and massive ascites was first admitted to our hospital in April, 2006. Although we conducted upper gastrointestinal endoscopy, total colonoscopy, chest-abdominal computed tomography, and FDG-PET, suspected with disseminated metastasis of cancer, we could not detect the original cancer lesion. Then, a diagnostic laparoscopy revealed many gray-colored nodules diffusely in the peritoneum. The peritoneal biopsy demonstrated that tumor cells grow papillarly and show a strongly positive image for calretinin, but a negative image for Ber-EP4. Therefore, we have diagnosed this case as a malignant peritoneal mesothelioma. Treatment with cisplatin 60 mg/m² and intraperitoneal instillation of mitomycin C 10 mg/m² were not so effective. Then, cisplatin 60 mg/m² and gemcitabine 1,000 mg/m² were administered biweekly. The tumor marker decreased remarkably and the massive ascites disappeared. Therefore, the chemotherapy could be done on an outpatient basis.