Related to the treatment of peritoneal mesothelioma

Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma more common in women, the cause is unknown, occur in the pelvic or accessories around, showing single or multiple cystic masses; patients often palpable abdominal mass due to the treatment. Malignant peritoneal mesothelioma (PMM) account for about 30% of malignant mesothelioma; its occurrence is closely related with exposure to asbestos, about 5% of patients had history of exposure; asbestos fiber intake by mouth, after translocation through the intestinal wall into the peritoneal and pleural metastasis from disease or from. From exposure to asbestos to diagnosis, the disease incubation period of up to 25 to 40 years. But the domestic 1951 ~ 1993 20 reported in the literature 161 cases of PMM in only 1 case had history of exposure to asbestos. ZHOU Ya-kang and other reported 47 cases of mesothelioma there are eight cases of malignant peritoneal mesothelioma, as well as the author collected two cases have history of exposure to asbestos. In the absence of asbestos-exposed populations, its incidence rate is about 1 person / 1 million person-years may be related to certain viral infections and genetic factors. PMM has reported 1 cases of foreign patients come into contact with more than 40 years ago, thorium dioxide colloid (Thorotrast). PMM often occurs in men over the age of 40. Visceral or parietal peritoneum can suffer from; and tumors can be a direct violation of abdominal and pelvic organs; 50% ~ 70% of patients with lymphatic and / or hematogenous metastasis of liver, kidney, adrenal gland, lung, bone and so on.

PMM for the rare peritoneal malignancy, has always held that the prognosis is poor, so far there is no standardized treatment protocols, but this situation is expected to change. In recent years, based on surgery, chemotherapy, radiotherapy, immune therapy has been supplemented by a combination therapy began to take shape.

On the chief complaint of chronic abdominal pain, abdominal distention, the elderly patients, especially those with ascites, and (or) abdominal mass who, by ultrasound or CT examination confirmed the intra-abdominal mass or peritoneal nodules on; ascites was exudative ascites and transparent quality acid was significantly higher; serum CA125 increase should be highly suspected PMM. For these patients should be ultrasound or CT guided biopsy, laparoscopy, or laparotomy; in estimating the range of tumor spread, while visceral and parietal peritoneum in multiple biopsy to obtain adequate organization for pathological examination and organization of the immune or chemical examination. Most patients diagnosed PMM, has been difficult to completely remove the tumor surgery. If no obstruction performance, should provide 2 to 3 treatment-induced intra-abdominal chemotherapy, in order to minimize the surface of tumor growing in the intestine, in order to create the conditions for surgery and help clinicians master the tumor response to chemotherapy information. After induction chemotherapy in 2 months, the purposes of cytoreductive surgery, removal of peritoneal disease, so as to remove all tumor tissue. Intraoperative or early postoperative intraperitoneal should be given adjuvant chemotherapy, and adjuvant treatment with radiotherapy and BRM. On postoperative tumor recurrence, such as conditions permit, consideration should be given re-operation.