MALIGNANT PERITONEAL MESOTHELIOMA AFTER THOROTRAST EXPOSURE

A case of a malignant peritoneal mesothelioma in a 63-year-old male pa tient with a history of exposure to Thorotrast in 1945 is presented. T here was no history of exposure to asbestos. The clinical manifestatio n was a serosal effusion, which required weekly ascites puncture until therapy with intraperitoneal bleomycin was initiated. The latter trea tment led to a significant reduction of ascites without any influence on tumor progression. Unfortunately, intraperitoneal bleomycin was acc ompanied by pulmonary toxicity, but at a higher total dose than known for intravenous administration. Three years after diagnosis the patien t is still alive, without relapse of ascites production after bleomyci n had to be stopped. Considering the risk of pulmonary fibrosis with h igh-dose intraperitoneal bleomycin and the lack of efficacy on tumor r eduction, bleomycin seems to offer no advantage with respect to cispla tin.