A Case of Malignant Pleural Mesothelioma with Spermatic Cord and Peritoneal Involvement That Responded to Ipilimumab+Nivolumab Combination Therapy

Tsuruga Tatsuki, Fujimoto Hajime, Esumi Seiya, Esumi Maki, Tsuji Chikashi, Yagi Akihiko, Okano Tomohito, Tomaru Atsushi, Kobayashi Tetsu, Asayama Kentarou

doi:10.2482/haigan.63.887

<p>Background. Malignant mesothelioma is a rare, aggressive cancer with limited treatment options and a poor prognosis. Malignant pleural mesothelioma has shown a good therapeutic response to checkpoint inhibitors. In Japan, immune checkpoint inhibitors, including nivolumab and ipilimumab and their combination, have been approved for treating malignant pleural mesothelioma but not for other types of malignant mesothelioma. Case. A 72-year-old man consulted a local general hospital because of bilateral inguinal masses. The pathological examination of biopsy samples collected from the bilaterally enlarged spermatic cords were compatible with a diagnosis of malignant mesothelioma. The patient was referred to our hospital for multidisciplinary treatment. He initially received chemotherapy with cisplatin and pemetrexed and showed a good response. However, computed tomography subsequently showed increased right pleural thickening, right pleural effusion, and an enlarged spermatic cord lesion. He was treated with ipilimumab+nivolumab combination therapy. This therapy reduced the size of his spermatic cord lesion but failed to control his pleural lesion. He was subsequently treated with vinorelbine, which was also ineffective. Conclusion. This case illustrates the potential efficacy and limitations of immune checkpoint inhibitors for malignant mesothelioma.</p>

A Case of Malignant Pleural Mesothelioma with Spermatic Cord and Peritoneal Involvement That Responded to Ipilimumab+Nivolumab Combination Therapy

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