Primary papillary serous carcinoma of the peritoneum diagnosed by video-assisted thoracoscopic surgery: Report of a case

A 53-year-old woman who had end-stage renal disease and hypertension presented with back pain. Chest radiographs and chest computed tomography (CT) showed right pleural effusion with bilateral pleural masses. The patient underwent video-assisted thoracoscopic surgery (VATS) for a biopsy of the right pleural mass and for an evaluation of pleural effusion. A frozensection specimen suggested a papillary adenocarcinoma, which was confirmed to be metastatic primary papillary serous carcinoma of the peritoneum by immunohistochemistry, an elevated serum cancer antigen (CA-125) level, and abdominal CT findings. We found that the patient had been unfortunately misdiagnosed to have advanced colon cancer 11 years previously and thus had undergone a right hemicolectomy which was followed by six cycles of 5-fluorouracil chemotherapy. Despite this, she survived more than 10 years and was later correctly diagnosed by VATS of the pleural lesions and based on a review of the previous pathology. The patient was transferred to an oncologist to receive the proper chemotherapy with paclitaxel and carboplatin.