Case report and literature review: the effect of surgical management in intrathoracic pseudomyxoma peritonei

Background Intrathoracic metastasis in patients with pseudomyxoma peritonei is extremely rare and carries a poor prognosis. No standard treatment recommendations have been established, and it remains unclear whether surgical treatment can improve the long-term prognostic outcomes. Cases description A retrospective analysis of the clinical findings of six intrathoracic pseudomyxoma peritonei patients that underwent surgical treatment at the Aerospace Center Hospital between March 2013 and June 2022 was conducted. Five patients exhibited evidence of direct extension into the pleural cavity, and four underwent parietal/visceral pleurectomy to remove as much of the mucinous tissue from the thoracic cavity as possible. One patient underwent the resection of disseminated pleural and lung lesions followed by hyperthermic intrathoracic chemotherapy (HITHOC). One patient exhibited pulmonary metastases and underwent lobectomy. Macroscopic tumor resection was performed in all patients. Patients were monitored for a mean follow-up time of 24 months, and exhibited 1- and 3-year survival rates of 100% (6/6) and 33.3% (2/6), respectively. Conclusion Intrathoracic pseudomyxoma peritonei is a rare clinical disease associated with a poor prognosis that primarily results following injury to the diaphragm during the surgical treatment of pseudomyxoma peritonei. Cytoreductive surgery to treat thoracic tumors in combination with HITHOC can alleviate the symptoms of this condition and can contribute to better prognostic outcomes. However, it is important to remain attentive to the potential for perioperative complications.