Abstract

We report a rare case of synchronous malignant peritoneal mesothelioma of the biphasic histological type and neuroendocrine tumor (NET) of the rectum without history of asbestos exposure.
 During 2 years since manifestation of the disease the patient underwent 3 cytoreductive surgeries (CRS): removal of the tumor of the sigmoid mesentery, resection of the rectosigmoid junction completeness of cytoreduction (CC) 0 (2017), omentectomy and partial parietal peritonectomy CC-0 (2017), atypical resection of S2, S4, S5 liver, the removal of the abdominal tumor with left-sided en-block hemicolectomy, partial parietal peritonectomy, argon-plasma coagulation of tumor foci on the mesentery of the small intestine CC-2 (2018) and Transanal Minimally Invasive Surgery-removal of neuroendocrine rectal tumor (2017). The patient underwent hyperthermic intraperitoneal chemotherapy (HIPEC) twice (during 2nd and 3rd CRS). Different regimens of HIPEC were performed: cisplatin + doxorubicin (2017) and metamycin C (2018). The patient received 4 courses of adjuvant chemotherapy with cisplatin plus pemetrexed in 2017 and 3 courses of the chemotherapy with gemcitabine and carboplatin plus bevacizumab in 2018.
 The patient survived 21 months after the detection of malignant peritoneal mesothelioma in 2017 and died 4 months after the last cytoreductive surgery from the progression of the disease.
 Histological subtype of MPMP remains important factor in the prognosis of the disease even on the early stages though patient had received the most aggressive variant of special treatment. Minimally invasive treatment tactics of NET demonstrated clinical effectiveness.

Highlights

  • Since the 1990s, the techniques for cancer diagnostics and treatment have greatly improved worldwide, which have increased the survival period of cancer patients

  • The aim of the research was to discuss a case of synchronous malignant peritoneal mesothelioma of the biphasic histological type and neuroendocrine tumor (NET) of the rectum without history of asbestos exposure and to analyze the outcomes of the performed treatment

  • Both MPMP and NET of the rectum could be diagnosed on the late stages due to their asymptomatic clinics

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Summary

Introduction

Since the 1990s, the techniques for cancer diagnostics and treatment have greatly improved worldwide, which have increased the survival period of cancer patients. The prolonged overall survival of cancer patients led to an increase in the incidence of multiple primary malignant tumors (two or more histologically distinct malignant tumors that appeared not due to recurrence, metastasis or local spread in the same individual). The first report about multiple primary malignant neoplasms in a single patient was published at the end of the 19th century [1]. Several papers worldwide have addressed this issue and the prevalence of multiple primary malignant neoplasms reported varies from 0.734 % to 11.7 % [2]. Multiple neoplasms could be defined by when they occur as synchronous and metachronous. The co-existence of malignant peritoneal mesothelioma and neuroendocrine tumor of the rectum is a rare entity

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