Epithelioid pleural mesothelioma successfully treated with perioperative immunotherapy: a case report

• Published in: General Thoracic and Cardiovascular Surgery Cases 2024-06, Vol.3 (1), p.31
• Main Authors: Yamazaki, Gaku, Fujiwara-Kuroda, Aki, Muto, Jun, Ujiie, Hideki, Aragaki, Masato, Furuta, Megumi, Ohno, Sakurako, Hatanaka, Kanako C, Hatanaka, Yutaka, Matsuno, Yoshihiro, Kato, Tatsuya
• Format: Article
• Language: English
• Subjects: Case Report
• ISSN: 2731-6203; 2731-6203
• DOI: 10.1186/s44215-024-00157-3

Pleural mesothelioma, characterized by a dismal prognosis even with multimodal therapy, has seen emerging interest in immune checkpoint inhibitors (ICIs) due to their demonstrated efficacy. Here, we present a case of epithelioid-type pleural mesothelioma with chest wall invasion treated with definitive ICI therapy, resulting in a remarkable pretreatment effect. A 46-year-old man was diagnosed with an abnormal chest shadow on a medical check, and a computed tomography scan showed pleural thickening at the dorsal right upper chest wall. One of the nodules was suspected to have invaded the chest wall. A needle biopsy revealed epithelioid-type pleural mesothelioma. After five cycles of nivolumab plus ipilimumab, he underwent right pleurectomy/decortication (P/D). Pathological examination revealed a significant treatment effect, showing numerous lymphocytes infiltrating the tumor nodule and viable tumor cells localized at approximately 6 mm. Although further accumulation of cases is required to evaluate the effectiveness and case selection, P/D after immunotherapy is a useful curative treatment option for advanced pleural mesothelioma.