Z Gastroenterol 2020; 58(02): 146-151
DOI: 10.1055/a-1083-6962
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Das diffuse maligne peritoneale Mesotheliom (DMPM) – eine seltene Diagnose

Diffuse malignant peritoneal mesothelioma (DMPM) – a rare diagnosis
Victoria Susanne Antonia Habbel
1   Asklepios Campus Hamburg, Medizinische Fakultät der Semmelweis Universität, Hamburg, Germany
,
Elisa Annabelle Mahler
2   Klinik für Allgemein- und Viszeralchirurgie, chirurgische Onkologie, Asklepios Klinik Barmbek, Hamburg, Germany
,
Bernd Feyerabend
3   MVZ Hanse Histologikum GmbH, Hamburg, Germany
,
Karl-Jürgen Oldhafer
1   Asklepios Campus Hamburg, Medizinische Fakultät der Semmelweis Universität, Hamburg, Germany
,
Michael Josef Lipp
1   Asklepios Campus Hamburg, Medizinische Fakultät der Semmelweis Universität, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

19 April 2019

11 December 2019

Publication Date:
12 February 2020 (online)

Zusammenfassung

Das diffuse maligne peritoneale Mesotheliom (DMPM) ist eine seltene Diagnose. Es tritt häufiger bei Männern als bei Frauen auf. Die Symptome sind vor allem unspezifische abdominelle Beschwerden, was die Diagnosestellung erschwert. Die Ursachen des DMPM sind noch nicht ausreichend geklärt. Ca. 7 % der peritonealen Mesotheliome lassen sich auf eine Asbestexposition zurückführen. Das DMPM war bis zur Entwicklung des Therapiekonzepts der systematischen chirurgischen Zytoreduktion (CRS) und anschließenden hyperthermen intraperitonealen Chemotherapie (HIPEC) eine fatale Diagnose mit einer medianen Lebenserwartung von 4–13 Monaten. Mit der CRS und HIPEC verbesserte sich die Prognose des DMPM deutlich auf 30–92 Monate heutzutage. Das vorliegende Fallbeispiel stellt die heute mögliche Therapie und deren Ergebnisse vor.

Abstract

Diffuse malignant peritoneal mesothelioma (DMPM) is a rare diagnosis, found more frequently in men than in women. Symptoms are unspecific abdominal disorders making that diagnosis difficult to set. Causes of DMPM are yet to be discovered in entirety. Asbestos exposure is the reason for approximately 7 % of all peritoneal mesotheliomas. Until the evaluation of systematic cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) DMPM was a fatal diagnosis with a median overall survival (OS) of 4–13 months. The prognosis of DMPM dramatically improved with implementation of CRS and HIPEC to an OS of 30–92 month nowadys. CRS and HIPEC were performed in this case.

 
  • Literatur

  • 1 Sridhar KS, Doria R, Raub WA. et al. New strategies are needed in diffuse malignant mesothelioma. Cancer 1992; 70 (12) 2969-2979
  • 2 Sebbag GYH, Shmookler HM. et al. Results of treatment of 33 patients with peritoneal mesothelioma. Br J Surg 2000; 87 (11) 1587-1593
  • 3 Salo SAS, Ilonen I, Laaksonen S. et al. Malignant Peritoneal Mesothelioma: Treatment Options and Survival. Anticancer research 2019; 39: 839-845
  • 4 Salo SAS, Ilonen I, Laaksonen S. et al. Epidemiology of malignant peritoneal mesothelioma: A population-based study. Cancer Epidemiol 2017; 51: 81-86
  • 5 Gatta G, van der Zwan JM, Casali PG. et al. Rare cancers are not so rare: the rare cancer burden in Europe. European journal of cancer 2011; 47: 2493-2511
  • 6 Yan TDEG, Alderman R, Marquardt CE. et al. Morbidity and mortality assessment of cytoreductive surgery and perioperative intraperitoneal chemotherapy for diffuse malignant peritoneal mesothelioma: a prospective study of 70 consecutive cases. Ann Surg Oncol 2007; 14: 515-525
  • 7 Feldman AL, Libutti SK, Pingpank JF. et al. Analysis of factors associated with outcome in patients with malignant peritoneal mesothelioma undergoing surgical debulking and intraperitoneal chemotherapy. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 2003; 21: 4560-4567
  • 8 Sugarbaker PH. Managing the peritoneal surface component of gastrointestinal cancer. Part 2. Perioperative intraperitoneal chemotherapy. Oncology (Williston Park) 2004; 18: 207-219 ; discussion 220–222, 227–228, 230
  • 9 Robinson BWS LR. Advances in malignant mesothelioma. The New England journal of medicine 2005; 353: 1591-1603
  • 10 Larson T, Melnikova N, Davis SI. et al. Incidence and descriptive epidemiology of mesothelioma in the United States, 1999–2002. Int J Occup Environ Health 2007; 13: 398-403
  • 11 Alexander Jr HR, Burke AP. Diagnosis and management of patients with malignant peritoneal mesothelioma. J Gastrointest Oncol 2016; 7: 79-86
  • 12 http://www.ruhr-uni-bochum.de/pathologie/mesotheliomregister/panel.html
  • 13 Ordonez NG. The diagnostic utility of immunohistochemistry and electron microscopy in distinguishing between peritoneal mesotheliomas and serous carcinomas: a comparative study. Mod Pathol 2006; 19: 34-48
  • 14 al KYe. Two cases of malignant peritoneal mesothelioma without asbestos exposure: cytologic and immunohistochemical features. Ann Diagn Pathol 2013; 17: 99-103
  • 15 Lin RTTK, Karjalainen A, Hoshuyana T. et al. Ecological association between asbestos-related diseases and historical asbestos consumption: an international analysis. Lancet 2017; 369: 844-849
  • 16 Shivapurkar N, Wiethege T, Wistuba II. et al. Presence of simian virus 40 sequences in malignant mesotheliomas and mesothelial cell proliferations. J Cell Biochem 1999; 76: 181-188
  • 17 Weissmann LB, Corson JM, Neugut AI. et al. Malignant mesothelioma following treatment for Hodgkinʼs disease. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 1996; 14: 2098-2100
  • 18 Chang ET, Lau EC, Mowat FS. et al. Therapeutic radiation for lymphoma and risk of second primary malignant mesothelioma. Cancer Causes Control 2017; 28: 971-979
  • 19 De Bruin ML, Burgers JA, Baas P. et al. Malignant mesothelioma after radiation treatment for Hodgkin lymphoma. Blood 2009; 113: 3679-3681
  • 20 Tsuruya K, Matsushima M, Nakajima T. et al. Malignant peritoneal mesothelioma presenting umbilical hernia and Sister Mary Josephʼs nodule. World J Gastrointest Endosc 2013; 5: 407-411
  • 21 Acherman YI, Welch LS, Bromley CM. et al. Clinical presentation of peritoneal mesothelioma. Tumori 2003; 89: 269-273
  • 22 Reuter K, Raptopoulos V, Reale F. et al. Diagnosis of peritoneal mesothelioma: computed tomography, sonography, and fine-needle aspiration biopsy. American journal of roentgenology 1983; 140: 1189-1194
  • 23 Yan TD, Haveric N, Carmignani CP. et al. Abdominal computed tomography scans in the selection of patients with malignant peritoneal mesothelioma for comprehensive treatment with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Cancer 2005; 103: 839-849
  • 24 Low RN, Barone RM. Combined diffusion-weighted and gadolinium-enhanced MRI can accurately predict the peritoneal cancer index preoperatively in patients being considered for cytoreductive surgical procedures. Ann Surg Oncol 2012; 19: 1394-1401
  • 25 Hassan R, Remaley AT, Sampson ML. et al. Detection and quantitation of serum mesothelin, a tumor marker for patients with mesothelioma and ovarian cancer. Clinical cancer research: an official journal of the American Association for Cancer Research 2006; 12: 447-453
  • 26 Baratti D, Kusamura S, Martinetti A. et al. Circulating CA125 in patients with peritoneal mesothelioma treated with cytoreductive surgery and intraperitoneal hyperthermic perfusion. Ann Surg Oncol 2007; 14: 500-508
  • 27 Sugarbaker PH, Yan TD, Stuart OA. et al. Comprehensive management of diffuse malignant peritoneal mesothelioma. European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2006; 32: 686-691
  • 28 Eltabbakh GH, Piver MS, Hempling RE. et al. Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma. Journal of surgical oncology 1999; 70: 6-12
  • 29 Sugabaker PH WL, Mohamed F, Glehen O. A review of peroitoneal mesothelioma at the Washington Cancer Institute. Surg Oncol Clin N Am 2003; 12: 605-621
  • 30 Wagmiller JA, Keohan ML, Chabot JA. et al. Peritoneal mesothelioma: The Columbia experience. In: Pass HI, Vogelzang NJ, Carbone M. editors. Malignant mesothelioma. Advances in pathogenesis, diagnosis, and translational therapies. NY: Springer Verlag; 2005: 723-731
  • 31 Yan TDDM, Baratti D, Kusamura S. et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 2009; 27: 6237-6242
  • 32 Lemoine L, Sugarbaker P, Van der Speeten K. Drugs, doses, and durations of intraperitoneal chemotherapy: standardising HIPEC and EPIC for colorectal, appendiceal, gastric, ovarian peritoneal surface malignancies and peritoneal mesothelioma. International journal of hyperthermia: the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 2017; 33: 582-592
  • 33 Levine EA, Stewart JH, Shen P. et al. Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients. Journal of the American College of Surgeons 2014; 218: 573-585
  • 34 Heller DR, Chiuzan C, Taub RN. et al. Recurrence of Optimally Treated Malignant Peritoneal Mesothelioma with Cytoreduction and Heated Intraperitoneal Chemotherapy. Ann Surg Oncol 2017; 24: 3818-3824
  • 35 Alexander Jr HR, Bartlett DL, Pingpank JF. et al. Treatment factors associated with long-term survival after cytoreductive surgery and regional chemotherapy for patients with malignant peritoneal mesothelioma. Surgery 2013; 153: 779-786
  • 36 Helm JH, Miura JT, Glenn JA. et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: a systematic review and meta-analysis. Ann Surg Oncol 2015; 22: 1686-1693