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Malignant peritoneal mesothelioma after Thorotrast exposure
C Stey1, U Landolt-Weber, W Vetter
1Department of Internal Medicine, University Hospital, Zürich, Switzerland.
American Journal of Clinical Oncology
|August 1, 1995
Summary
This case study highlights a malignant peritoneal mesothelioma patient exposed to Thorotrast. Intraperitoneal bleomycin reduced ascites but caused pulmonary toxicity, showing limited benefit over cisplatin.
Area of Science:
- Oncology
- Thorium-232 Toxicology
Background:
- Presents a rare case of malignant peritoneal mesothelioma in a 63-year-old male.
- Notes a significant history of Thorotrast exposure in 1945, with no asbestos exposure.
- Highlights the diagnostic challenge and initial management of malignant peritoneal mesothelioma.
Observation:
- Clinical manifestation included recurrent serosal effusion requiring frequent paracentesis.
- Treatment involved intraperitoneal bleomycin, leading to initial ascites reduction.
- Observed significant pulmonary toxicity associated with intraperitoneal bleomycin administration.
Findings:
- Intraperitoneal bleomycin effectively reduced ascites but did not impact tumor progression.
- Pulmonary toxicity occurred at a higher total dose than with intravenous administration.
- The patient remained alive and free of ascites recurrence for three years after bleomycin cessation.
Implications:
- High-dose intraperitoneal bleomycin carries a risk of pulmonary fibrosis.
- Bleomycin's efficacy on tumor reduction appears limited, suggesting no advantage over cisplatin.
- This case underscores the importance of considering past Thorotrast exposure in mesothelioma etiology and treatment response.