Hyperthermic intraperitoneal chemotherapy in primary peritoneal cancer: Our experience in a young male

Abstract

Primary peritoneal carcinomatosis (PPC) is a rare tumor, described in the literature almost exclusively in women. Patients with peritoneal carcinomatosis were considered incurable with low survival rates. This underwent a paradigm shift with hyperthermic intraperitoneal chemotherapy (HIPEC) after optimal cytoreductive surgery which changed the entire scenario. This case report describes the management of a 28-year-old male patient who was diagnosed to have PPC when he presented with massive ascites, who underwent cytoreductive surgery combined with HIPEC in our hospital. This procedure was complex for both the surgical team due to an extensive surgery, but also the anesthetist during the hyperthermic phase where the chemotherapy was administered. The post-operative recovery in such a case is also many times stormy and requires extreme vigilance. We had major challenges such as prolonged surgery, massive blood loss, temperature management, maintaining adequate urine output, and post-operative critical care. Extensive pre-operative preparation and proper coordination with the multidisciplinary team led us to handle the condition satisfactorily. The PPC in a young patient itself is a rare which enthuses us to report the case.