内容紹介
Summary
A 65-year-old man was admitted to our hospital complaining of general malaise, anorexia and weight loss. A computed tomography(CT)scan showed massive ascites and multiple peritoneal masses. Although adenocarcinoma was suspected based on the cytology of the ascites, we were unable to determine the site of origin. We next performed a laparoscopy and a biopsy of the tumor on the omentum. The laparoscopy showed small, white, hard nodules that were disseminated throughout the abdominal cavity, and histological diagnosis confirmed malignant peritoneal mesothelioma. The patient was administered chemotherapeutic treatment of cisplatin and pemetrexed. After treatment, the ascites decreased; however, tumor regression was not observed. The patient's performance status gradually decreased, and he died on hospital day 104. Prognosis of malignant peritoneal mesothelioma remains poor, and malignant peritoneal mesothelioma should be considered when diagnosing peritoneal tumors.
要旨
症例は65歳,男性。全身倦怠感,食欲不振,体重減少があり,当科に紹介受診した。CTで大量腹水と腹膜に多発腫瘍が認められた。腹水細胞診で腺癌が疑われたが,原発巣は認めなかった。審査腹腔鏡による生検で悪性腹膜中皮腫と診断した。cisplatin(CDDP)+pemetrexed(PEM)療法を行った。CTで腹水の減少は認めたが主病巣は変化を認めず,performance statusの低下に伴い化学療法は中止し,第104病日に死亡した。悪性腹膜中皮腫は予後不良であり,腹膜腫瘍を認めた場合,腹膜中皮腫を鑑別に入れる必要がある。
目次
A 65-year-old man was admitted to our hospital complaining of general malaise, anorexia and weight loss. A computed tomography(CT)scan showed massive ascites and multiple peritoneal masses. Although adenocarcinoma was suspected based on the cytology of the ascites, we were unable to determine the site of origin. We next performed a laparoscopy and a biopsy of the tumor on the omentum. The laparoscopy showed small, white, hard nodules that were disseminated throughout the abdominal cavity, and histological diagnosis confirmed malignant peritoneal mesothelioma. The patient was administered chemotherapeutic treatment of cisplatin and pemetrexed. After treatment, the ascites decreased; however, tumor regression was not observed. The patient's performance status gradually decreased, and he died on hospital day 104. Prognosis of malignant peritoneal mesothelioma remains poor, and malignant peritoneal mesothelioma should be considered when diagnosing peritoneal tumors.
要旨
症例は65歳,男性。全身倦怠感,食欲不振,体重減少があり,当科に紹介受診した。CTで大量腹水と腹膜に多発腫瘍が認められた。腹水細胞診で腺癌が疑われたが,原発巣は認めなかった。審査腹腔鏡による生検で悪性腹膜中皮腫と診断した。cisplatin(CDDP)+pemetrexed(PEM)療法を行った。CTで腹水の減少は認めたが主病巣は変化を認めず,performance statusの低下に伴い化学療法は中止し,第104病日に死亡した。悪性腹膜中皮腫は予後不良であり,腹膜腫瘍を認めた場合,腹膜中皮腫を鑑別に入れる必要がある。