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Updated: May 8, 2026
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Therapeutic strategies for well-differentiated papillary mesothelioma of the peritoneum
Young Ki Lee1, Hyun Jung Jun, Ji Hae Nahm
1*Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. hyosong77@yuhs.ac.
Objective:
Well-differentiated papillary mesothelioma is an uncommon subtype of mesothelioma with a frequently indolent course, although it occasionally manifests in a more aggressive form. To establish a treatment strategy for this rare disease, we report the clinical characteristics and outcomes of 15 patients with well-differentiated papillary mesothelioma.
Methods:
All pathologically diagnosed well-differentiated papillary mesothelioma cases were reviewed between 1998 and 2012.
Results:
Of the 15 cases, 8 and 7 presented with single and multiple lesions, respectively. All cases with single lesions were asymptomatic, while 4 out of the 7 cases with multiple lesions were symptomatic. After tumor excision, none of the eight single-lesion cases experienced tumor recurrence. Among the other seven cases with multiple lesions, only one patient with disseminated lesions died due to disease burden. Five patients with multiple lesions received cisplatin-based intravenous or intraperitoneal chemotherapy, with a mix of complete (n= 2) and partial (n= 2) responses observed. Of particular note, one patient receiving cisplatin and pemetrexed combination chemotherapy experienced complete tumor resolution without any serious toxicity.
Conclusions:
We recommend different treatment strategies based on the disease status. If the tumor is completely resectable, an excisional biopsy seems to be sufficient. If complete resection is unavailable for the asymptomatic patient with a localized tumor extent, close follow-up is an appropriate option. When the tumor is extensive or accompanied by symptoms, chemotherapy should be strongly considered.
Insights
Treatment for well-differentiated papillary mesothelioma depends on disease extent. Complete resection is sufficient for localized tumors, while chemotherapy is recommended for extensive or symptomatic cases.
Area of Science:
- Oncology
- Pathology
Background:
- Well-differentiated papillary mesothelioma is a rare subtype of mesothelioma.
- It typically follows an indolent course but can be aggressive.
Purpose of the Study:
- To establish treatment strategies for well-differentiated papillary mesothelioma.
- To report clinical characteristics and outcomes of 15 patients.
Main Methods:
- Retrospective review of pathologically diagnosed cases between 1998 and 2012.
- Analysis of clinical presentation, treatment, and outcomes.
Main Results:
- 15 cases reviewed: 8 single lesions (asymptomatic, no recurrence post-excision), 7 multiple lesions (some symptomatic).
- Chemotherapy (cisplatin-based) showed mixed responses; one patient achieved complete resolution with cisplatin and pemetrexed.
- One patient with disseminated disease died.
Conclusions:
- Surgical excision is sufficient for completely resectable tumors.
- Close follow-up is suitable for asymptomatic, localized tumors without complete resection.
- Chemotherapy is strongly considered for extensive or symptomatic disease.
