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Extended pleuropneumonectomy for malignant mesothelioma a case report

, : Extended pleuropneumonectomy for malignant mesothelioma a case report. Journal of the Japanese Association for Thoracic Surgery 36(3): 429-434

A 51-year-old man underwent thoractomy under a diagnosis of unclassified malignant tumor of the left upper lobe. The tumor which located adjacent to the visceral pleura in the lung parenchyma was confirmed as mixed type, malignant mesothelioma by intraoperative cytodiagnosis. Simultaneously, many small lesions looked like metastases or multicentric origin were observed on the pleural surface. Therefore, the operation was resulted in palliative resection. Subsequently, the residual tumors gradually enlarged CT scan showed invasion of tumors into the chest wall, diaphragm and pericardium. Because of pain and hemoptysis, performance with extremely deteriorated. Therefore, we attempted to extended pleuropneumonectomy combined with resection of those surrounding structures 2 years after the initial operation. As a result of the en bloc resection, this patient is alive without recurrence for 3 years after the initial operation. The clinical course suggests that extended pleuropneumonectomy for removal of invasive mesothelioma can be accomplished safely and without major complication. When possible, this procedure appears to carry the best palliation or the only opportunity for cure.

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