Navigating Fertility Preservation in Epithelioid Peritoneal Mesothelioma: A Case Study

Area of Science:

• Oncology
• Reproductive Medicine

Background:

• Malignant peritoneal mesothelioma (MPM) is a rare, aggressive neoplasm.
• Low-grade epithelioid subtypes pose diagnostic and therapeutic challenges.
• Nonspecific symptoms often lead to delayed diagnosis, relying on histopathology and immunohistochemistry.

Purpose of the Study:

• To review current research on MPM epidemiology, diagnosis, and treatment.
• To focus on fertility preservation and successful childbirth post-treatment.
• To present a case report illustrating these challenges and outcomes.

Main Methods:

• Literature review of MPM epidemiology, diagnosis, and treatment.
• Case report of a nulliparous woman with MPM.
• Treatment involved chemotherapy, immunotherapy, in vitro fertilization (IVF), and surgical excision of residual tumors.

Main Results:

• The patient achieved complete disease control with chemotherapy and immunotherapy.
• Fertility was preserved, leading to successful IVF and embryo transfer.
• Residual intra-abdominal tumors were discovered and excised during a cesarean section at 30 weeks 2 days gestation.

Conclusions:

• MPM diagnosis is often delayed due to nonspecific symptoms.
• Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) improve survival for operable cases.
• Systemic therapies and immune-checkpoint inhibitors (ICIs) are options for inoperable cases, but further research on fertility impact is needed.