[Malignant Pleural Mesothelioma with Excessive Inflammation and High Level of Interleukin 6 - A Case Report]

Malignant mesothelioma is a rare aggressive solid tumor that is invariably incurable. A 23-year-old female patient with ascites, anemia, and high levels of ferritin and CRP was diagnosed with pleural mesothelioma by exploratory laparotomy. She remained asymptomatic, but 7 years later, she developed intractable diarrhea and fever. Systematic chemotherapy with both cisplatin and pemetrexed was administered. However, the treatment was discontinued due to side effects, after which time the diarrhea, ascites, and fever became progressively more severe. Hepatomegaly and hepatic siderosis also developed. At the same time, the patient's serum interleukin 6(IL-6)levels were abnormally high. Although there was a temporary symptomatic improvement after intraperitoneal injection of cisplatin, the intractable mesothelioma-associated symptoms returned a few days later. The patient died of liver failure 1 week later. The poor prognosis in this case was due to symptoms associated with the high IL-6 level. There are limited medically proven treatments, and it is important to develop new treatments. Therefore, "anti-IL-6 therapy" may have to be tested as a potential treatment for symptoms associated with high IL-6 levels.