When the extension of PMP occurred

When the extension of PMP occurred into the thoracic cavity (an extremely rare scenario) a very poor prognosis is predictable. Since clear evidence on the best treatment to be adopted is not available, systemic palliative chemotherapy remains the usual treatment option. However, on the basis of the same rationale reported above, few authors have reported the resection of intrathoracic lesions, and surgery with or without hyperthermic intrathoracic chemotherapy (HITHOC) in specialized centers4. We herein report a multimodal aggressive treatment consisting in iterative hyperthermic intraperitoneal chemotherapy (HIPEC) for PMP with peritoneal spread followed by HITHOC 9 months later for a left pleural recurrence of disease.