Novel Use of Bromelain and Acetylcysteine (BromAc®) for Pleural Involvement in Pseudomyxoma Peritonei

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Anthony R Lam1, Khalil Bazzi1, Sarah J Valle1

  • 1Department of Surgery, Peritonectomy Unit, St George Hospital, Kogarah, New South Wales, Australia.

Case Reports in Oncology
|May 12, 2021
PubMed

Insights

Pseudomyxoma peritonei (PMP) is a rare condition. This study explores Bromelain and acetylcysteine (BromAc®) as a novel mucolytic treatment for pleural adenomucinosis, showing varied responses based on tumor hardness.

Area of Science:

  • Oncology
  • Pulmonology
  • Gastroenterology

Background:

  • Pseudomyxoma peritonei (PMP) is a rare mucinous neoplasm, frequently originating in the appendix.
  • Pleural involvement in PMP is uncommon and challenging to manage.
  • Current treatment for intrathoracic PMP involves cytoreductive surgery and hyperthermic chemotherapy, with recurrence posing significant risks.

Observation:

  • This report details the first two cases of Bromelain and acetylcysteine (BromAc®) administered directly into pleural adenomucinosis.
  • BromAc® is a novel mucolytic agent with demonstrated efficacy in dissolving mucinous tumors.
  • The study observed significant differences in treatment response between the two patients.

Findings:

  • The varied responses to BromAc® were likely attributed to differences in the hardness of the mucinous tumors.
  • Direct instillation of BromAc® facilitated tumor dissolution and aspiration in pleural adenomucinosis.
  • The safety profile and objective response of BromAc® in pleural disease warrant further investigation.

Implications:

  • BromAc® represents a potential new therapeutic option for managing pleural adenomucinosis, particularly in recurrent or inoperable cases.
  • Tumor characteristics, such as hardness, may influence treatment outcomes with BromAc®.
  • Further research is needed to optimize the use of BromAc® and understand its full therapeutic potential in rare mucinous diseases.
Keywords:
AcetylcysteineBromelainPleural adenomucinosisPseudomyxoma peritonei

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