Successful sequential hyperthermic intrathoracic chemotherapy (HITHOC) for bilateral malignant pleural effusion from recurrent ovarian granulosa cell tumors: A novel approach and case report.

OBJECTIVE: To report the first case of hyperthermic intrathoracic chemotherapy (HITHOC) combined with two-stage video-assisted thoracoscopic surgery (VATS) with a one-week interval between procedures to treat recurrent adult ovarian granulosa cell tumors (AGCTs) with bilateral malignant pleural effusion (MPE).

CASE REPORT: A 59-year-old woman with the fourth recurrent AGCT presented with bilateral pleural masses and effusion 18 years after the initial diagnosis. After a multidisciplinary discussion, two-stage VATS for total pleural tumor resection with HITHOC (cisplatin 60 mg/m2, 42 °C, 60 min) was performed with a one-week interval between procedures. Complete cytoreduction in bilateral pleural cavities was achieved in both procedures. The post-operative course was uneventful with mild chest discomfort. The patient completed salvage chemotherapy with carboplatin/paclitaxel and diaphragmatic radiotherapy. At 24 months follow-up, she remains disease-free.

CONCLUSIONS: Two-stage VATS with HITHOC appears to be a feasible and safe approach for selected cases of recurrent AGCT with bilateral MPE.