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Campos NMF, Almeida V, Curvo Semedo L. Peritoneal disease: key imaging findings that help in the differential diagnosis. Br J Radiol 2022; 95:20210346. [PMID: 34767464 PMCID: PMC8822557 DOI: 10.1259/bjr.20210346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The peritoneum is a unique serosal membrane, which can be the site of primary tumors and, more commonly, secondary pathologic processes. Peritoneal carcinomatosis is the most common malignant condition to affect the peritoneal cavity, and the radiologist plays an important role in making the diagnosis and assessing the extent of disease, especially in sites that may hinder surgery. In this review, we address the role of the radiologist in the setting of peritoneal pathology, focusing on peritoneal carcinomatosis as this is the predominant malignant process, followed by revising typical imaging findings that can guide the differential diagnosis.We review the most frequent primary and secondary peritoneal tumor and tumor-like lesions, proposing a systemic approach based on clinical history and morphological appearance, namely distinguishing predominantly cystic from solid lesions, both solitary and multiple.
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Affiliation(s)
- Nuno M F Campos
- Department of Medical Imaging, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Vânia Almeida
- Department of Pathology, Coimbra Hospital and University Centre, Coimbra, Portugal
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Gan J, Herzog J, Smith DA, Vos D, Kikano E, Tirumani SH, Ramaiya NH. Primary peritoneal serous carcinoma: a primer for radiologists. Clin Imaging 2021; 83:56-64. [PMID: 34974267 DOI: 10.1016/j.clinimag.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/14/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Abstract
Primary peritoneal serous carcinoma (PPSC) is a rare primary peritoneal tumor characterized by a unique range of clinical features and imaging findings. Though it shares many clinical, histologic, and imaging features with serous ovarian carcinoma, it remains a distinct clinical entity. Although less common than its primary ovarian counterpart, PPSC is characterized by a prognosis that is often equally poor with presentations common in late stages of disease. Key imaging modalities used in the evaluation of PPSC include ultrasound, CT, MRI, and PET/CT. For radiologists, an understanding of the pertinent imaging findings, pathologic correlations, and clinical features of PPSC is essential for arriving at the correct diagnosis and guiding the subsequent appropriate management of this complex malignancy.
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Affiliation(s)
- Jonathan Gan
- Case Western Reserve University, School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Jackson Herzog
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Daniel A Smith
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America.
| | - Derek Vos
- Case Western Reserve University, School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Elias Kikano
- Department of Radiology, Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115, United States of America
| | - Sree H Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Nikhil H Ramaiya
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America
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Blontzos N, Vafias E, Vorgias G, Kalinoglou N, Iavazzo C. Primary peritoneal serous papillary carcinoma: a case series. Arch Gynecol Obstet 2019; 300:1023-1028. [PMID: 31486887 DOI: 10.1007/s00404-019-05280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 08/22/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To present the clinical and laboratory characteristics, as well as the management, of patients with primary peritoneal serous papillary carcinoma (PPSPC). METHODS This is a retrospective study of 19 patients with PPSPC who underwent debulking surgery followed by first line chemotherapy and were managed in Metaxa Memorial Cancer Hospital between January 2002 and December 2017. RESULTS The median age of the patients was found to be 66 years (range 44-76 years). Clinical presentation of PPSPC included abdominal distention and pain, constipation, as well as loss of appetite and weight gain. Two of the patients did not mention any symptomatology and the disease was suspected by an abnormal cervical smear and elevated CA125 levels respectively. Biomarkers measurement during the initial management of the patients revealed abnormal values of CA125 for all the participants (median value 565 U/ml). Human epididymis secretory protein 4 (HE4) and ratios of blood count were also measured. Perioperative Peritoneal Cancer Index ranged from 6 to 20. Optimal debulking was achieved in 5 cases. All patients were staged as IIIC and IVA PPSPC and received standard chemotherapy with paclitaxel and carboplatin, whereas bevacizumab was added in the 5 most recent cases. Median overall survival was 29 months. CONCLUSION PPSPC is a rare malignancy, the management of which should take place in tertiary oncology centers.
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Affiliation(s)
- Nikolaos Blontzos
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Mpotasi 1, 17674, Piraeus, Athens, Greece.
| | - Evangelos Vafias
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Mpotasi 1, 17674, Piraeus, Athens, Greece
| | - George Vorgias
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Mpotasi 1, 17674, Piraeus, Athens, Greece
| | - Nikolaos Kalinoglou
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Mpotasi 1, 17674, Piraeus, Athens, Greece
| | - Christos Iavazzo
- Department of Gynecology, Metaxa Memorial Cancer Hospital, Mpotasi 1, 17674, Piraeus, Athens, Greece
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Lisi G, Campanelli M, Grande S, Mascagni D, Aronadio E, Palmieri G, Grande M. Seromucinous borderline tumor of the peritoneum. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Efthimiadis C, Ioannidis A, Kofina K, Grigoriou M. Primary solitary peritoneal tumor of the abdominal wall-report of a rare case and review of the literature. J Surg Case Rep 2017; 2017:rjx094. [PMID: 28616156 PMCID: PMC5462999 DOI: 10.1093/jscr/rjx094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 05/20/2017] [Indexed: 11/13/2022] Open
Abstract
Abdominal wall tumors are sometimes diagnosed as metastases of ovarian cancer, however, primary peritoneal tumors should be taken into consideration in the final diagnosis. A 49-year-old female patient was admitted in our Department for the excision of a pulpable abdominal wall lump, with no other abnormalities shown on imaging investigation. On histology examination, the excised specimen revealed characteristics of metastatic high-grade serous ovarian carcinoma. Total hysterectomy, bilateral oophorectomy, omentectomy and appendectomy were performed. No signs of malignancy were proved on histology, leading to the final diagnosis of a primary serous peritoneal tumor. This is the third described case of solitary primary serous peritoneal tumor located in the abdominal wall. This condition should be included in the differential diagnosis of a probable metastatic ovarian carcinoma, as both present similar histologic characteristics.
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Affiliation(s)
| | | | - Konstantinia Kofina
- Department of Surgery, Euromedica Medical Clinic, Thessaloniki 54645, Greece
| | - Marios Grigoriou
- Department of Surgery, Euromedica Medical Clinic, Thessaloniki 54645, Greece
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Krishnamurthy S, Balasubramaniam R. Role of Imaging in Peritoneal Surface Malignancies. Indian J Surg Oncol 2016; 7:441-452. [PMID: 27872533 PMCID: PMC5097766 DOI: 10.1007/s13193-016-0539-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 06/02/2016] [Indexed: 12/13/2022] Open
Abstract
Imaging plays a vital role in the evaluation of peritoneal malignancies. The presence of peritoneal metastases (PM) alters tumor staging, with direct implications in treatment choice and prognosis. Cytoreductive surgery (CRS) and Hyperthermic intraperitoneal chemotherapy (HIPEC) as a combined modality treatment have led to prolonged survival and even cure in selected patients with PM. Better outcomes are seen in patients with limited disease spread. Therefore, early diagnosis of peritoneal tumor seeding is essential. Despite significant advancement of technology, assessment of the origin of PM is often difficult, due partly to the complex peritoneal anatomy and partly due to the complex overlap of imaging features. Multidetector CT (MDCT) is the main stay due to its wide availbility, rapid evaluation, robust technique and good resolution. Imaging plays a vital role in selecting patients for the combined modality treatment. MRI is not as popular as CT due to limited availability, time required for the study and lack of experience with interpreting the results. PET-CT is useful in ruling out extra peritoneal disease and it is the CT component that is more reliable for predicting the disease extent. This article reviews the current use of various imaging modalities in various stages of treatment of patients with PM especially those undergoing CRS and HIPEC.
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Katabathina VS, Amanullah FS, Menias CO, Chen MM, Valente PT, Chintapalli KN, Prasad SR. Extrauterine Pelvic Serous Carcinomas: Current Update on Pathology and Cross-sectional Imaging Findings. Radiographics 2016; 36:918-32. [DOI: 10.1148/rg.2016150130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Arraiza M, Metser U, Vajpeyi R, Khalili K, Hanbidge A, Kennedy E, Ghai S. Primary cystic peritoneal masses and mimickers: spectrum of diseases with pathologic correlation. ACTA ACUST UNITED AC 2015; 40:875-906. [PMID: 25269999 DOI: 10.1007/s00261-014-0250-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cystic lesions within the peritoneum have been classified classically according to their lining on histology into four categories-endothelial, epithelial, mesothelial, and others (germ cell tumors, sex cord gonadal stromal tumors, cystic mesenchymal tumors, fibrous wall tumors, and infectious cystic peritoneal lesions). In this article, we will proceed to classify cystic peritoneal lesions focusing on the degree of radiological complexity into three categories-simple cystic, mildly complex, and cystic with solid component lesions. Many intra-abdominal collections within the peritoneal cavity such as abscess, seroma, biloma, urinoma, or lymphocele may mimic primary peritoneal cystic masses and need to be differentiated. Clinical history and imaging features may help differentiate intra-abdominal collections from primary peritoneal masses. Lymphangiomas are benign multilocular cystic masses that can virtually occur in any location within the abdomen and insinuate between structures. Ultrasound may help differentiate enteric duplication cysts from other mesenteric and omental cysts in the abdomen. Double-layered wall along the mesenteric side of bowel may suggest its diagnosis in the proper clinical setting. Characteristic imaging features of hydatid cysts are internal daughter cysts, floating membranes and matrix, peripheral calcifications, and collagenous pericyst. Non-pancreatic psuedocysts usually have a fibrotic thick wall and chylous content may lead to a fat-fluid level. Pseudomyxoma peritonei appears as loculated fluid collections in the peritoneal cavity, omentum, and mesentery and may scallop visceral surfaces. Many of the primary cystic peritoneal masses have specific imaging features which can help in accurate diagnosis and management of these entities. Knowledge of the imaging spectrum of cystic peritoneal masses is necessary to distinguish from other potential cystic abdominal mimicker masses.
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Affiliation(s)
- María Arraiza
- Joint Department of Medical Imaging, University Health Network - Mount Sinai Hospital - Women's College Hospital, University of Toronto, 585 University Avenue, Toronto, ON, M5G 2N2, Canada
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Primary and secondary disease of the peritoneum and mesentery: review of anatomy and imaging features. ACTA ACUST UNITED AC 2015; 40:626-42. [PMID: 25189130 DOI: 10.1007/s00261-014-0232-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The largest and most complex serosal membrane in the body, the peritoneum, lines the abdominal cavity, and the abdominopelvic viscera. It is frequently involved in a variety of benign and malignant processes. While secondary involvement of the peritoneum is more common, primary tumors can be a diagnostic challenge. Knowledge of the anatomy is crucial in understanding the various pathologic processes. Cross-sectional imaging plays an important role in diagnosing and evaluating the extent of the disease processes. This article reviews the imaging anatomy of the peritoneum and mesentery and the common pathologies involving it.
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Vicens RA, Patnana M, Le O, Bhosale PR, Sagebiel TL, Menias CO, Balachandran A. Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists. ACTA ACUST UNITED AC 2014; 40:436-56. [DOI: 10.1007/s00261-014-0224-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Chao KC, Chen YJ, Juang CM, Lau HY, Wen KC, Sung PL, Fang FY, Twu NF, Yen MS. Prognosis for advanced-stage primary peritoneal serous papillary carcinoma and serous ovarian cancer in Taiwan. Taiwan J Obstet Gynecol 2013; 52:81-4. [PMID: 23548224 DOI: 10.1016/j.tjog.2012.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2012] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To compare the prognosis of patients with advanced-stage primary peritoneal serous papillary carcinoma (PSPC) or papillary serous ovarian cancer (PSOC). MATERIALS AND METHODS This was a retrospective case-control study and included two study groups: one with stage III/IV PSPC (n = 38) patients and the other with PSOC (n = 53) patients. Patients were matched for histologic subtype (serous tumor), tumor stage, tumor grade, residual disease at the end of debulking surgery (primary or interval), and age (±5 years). RESULTS Mean age was significantly greater for patients with PSPC (63.03 ± 11.88 years) than for patients with PSOC (55.92 ± 12.56 years, p = 0.008). Optimal debulking surgery was performed initially in 71.9% of PSPC patients and 66.0% of PSOC patients. In addition, 93.9% of PSPC patients and 92.3% of PSOC patients were treated with platinum-paclitaxel chemotherapy. The frequency of high-grade tumors was significantly higher in the PSPC (100%) than in the PSOC group (68.3%; p < 0.001). Progression-free survival (PFS) was similar in the PSPC [median 12 months, 95% confidence interval (CI) 7.3-16.7] and PSOC groups (median 16.7 months, 95% CI 12.9-20.4; p = 0.470). Overall survival was shorter in the PSPC (median 62 months, 95% CI 19.6-104.4) than in the PSOC group (median 77.5 months, 95% CI 69.7-85.2; p = 0.006, log-rank statistic). CONCLUSION PFS was similar for advanced-stage PSPC and PSOC patients. Since the PSPC patients tended to be older and have more high-grade tumors, OS was shorter for PSPC than for POSC patients. Thus, management of the two types of cancer should not differ.
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Affiliation(s)
- Kuan-Chong Chao
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
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Abstract
Imaging plays a vital role in the evaluation of patients with suspected or proven peritoneal malignancy. Nevertheless, despite significant advances in imaging technology and protocols, assessment of peritoneal pathology remains challenging. The combination of complex peritoneal anatomy, an extensive surface area that may host tumour deposits and the considerable overlap of imaging appearances of various peritoneal diseases often makes interpretation difficult. Contrast-enhanced multidetector computed tomography (MDCT) remains the most versatile tool in the imaging of peritoneal malignancy. However, conventional and emerging magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT techniques offer significant advantages over MDCT in detection and surveillance. This article reviews established and new techniques in CT, MRI and PET imaging in both primary and secondary peritoneal malignancies and provides an overview of peritoneal anatomy, function and modes of disease dissemination with illustration of common sites and imaging features of peritoneal malignancy.
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Affiliation(s)
- Chirag M Patel
- Department of Diagnostic Imaging, Barts and the London NHS Trust, Bart's Cancer Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
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Tumors and pseudotumors of the secondary müllerian system: review with emphasis on cross-sectional imaging findings. AJR Am J Roentgenol 2011; 195:1452-9. [PMID: 21098209 DOI: 10.2214/ajr.10.4302] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Microscopic structures lined by müllerian epithelium are frequently seen outside the uterus and fallopian tubes and are termed "müllerian rests" or "secondary müllerian system." Varied entities ranging from benign endosalpingosis to highly malignant ovarian tumors are thought to be derived from the secondary müllerian system. Cross-sectional imaging findings of diseases and disorders of the secondary müllerian system are presented here. CONCLUSION Familiarity with a wide spectrum of diseases and disorders of the secondary müllerian system allows accurate diagnosis and management.
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Primary peritoneal carcinoma: computed tomography and magnetic resonance findings. J Comput Assist Tomogr 2008; 32:541-7. [PMID: 18664839 DOI: 10.1097/rct.0b013e318133a9d8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To present computed tomography (CT) and magnetic resonance imaging (MRI) findings of primary peritoneal carcinoma (PPC) at initial presentation (IP) and recurrent disease (RD). METHODS We studied 15 consecutive female patients (age range, 47-83 years; mean, 66.2 years) with pathologically proven PPC who underwent CT and/or MRI between July 2000 and December 2005. Preoperative radiological evaluation and postoperative follow-up was done with CT and/or magnetic resonance studies. All CT and MRI studies were evaluated retrospectively, independently, and blindly by 2 radiologists for the imaging findings of PPC. RESULTS The imaging findings were as follows: ascites, 2 of 2 at IP, 9 of 10 at RD; peritoneal thickening and enhancement, 1 of 2 at IP, 9 of 10 at RD; peritoneal nodules or bulky mass lesions, 1 of 2 at IP, 8 of 10 at RD; lymph node involvement, 1 of 2 at IP, 3 of 10 at RD; and distant metastases, 1 of 10 at RD. CONCLUSION Ascites, peritoneal thickening and enhancement, and peritoneal nodules or bulky mass lesions were the most frequent findings of PPC. Recurrent disease revealed similar findings compared with the IP.
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Levy AD, Arnáiz J, Shaw JC, Sobin LH. From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation. Radiographics 2008; 28:583-607; quiz 621-2. [PMID: 18349460 DOI: 10.1148/rg.282075175] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Primary peritoneal tumors are uncommon lesions that arise from the mesothelial or submesothelial layers of the peritoneum. Primary malignant mesothelioma, multicystic mesothelioma, primary peritoneal serous carcinoma, leiomyomatosis peritonealis disseminata, and desmoplastic small round cell tumor are the most prominent of these rare lesions. Primary malignant mesothelioma is a highly aggressive malignancy that occurs most commonly in older men and that has a strong association with high levels of asbestos exposure. It manifests most often as diffuse sheetlike or nodular thickening of the peritoneal surfaces, but it may occasionally be a localized mass. Multicystic mesothelioma occurs most frequently in women and has benign or indolent biologic behavior in the majority of patients. It is a multilocular cystic mass that arises from the pelvic peritoneal surfaces. Primary peritoneal serous carcinoma occurs almost exclusively in women. It is histologically identical to ovarian serous carcinoma and may be indistinguishable from metastatic ovarian carcinoma at imaging studies. Leiomyomatosis peritonealis disseminata is a rare, benign proliferative process that also occurs exclusively in women and is characterized by multiple smooth muscle nodules throughout the peritoneum. Desmoplastic small round cell tumor is a highly aggressive malignancy of unknown origin that occurs most often in the peritoneal cavity of young men. This unusual group of tumors is linked together by a common site of origin and imaging manifestations that mimic those of peritoneal carcinomatosis. Knowledge of the spectrum of imaging findings in this group of primary peritoneal tumors, along with their clinical and pathologic characteristics, is important in the evaluation of patients with diffuse peritoneal disease.
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Affiliation(s)
- Angela D Levy
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799, USA.
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Ruiz-Tovar J, Pérez de Oteyza J, Rojo R, Collado MV, García Villanueva A. Papillary serous carcinoma of peritoneum: presentation of 2 cases. Clin Transl Oncol 2006; 8:758-60. [PMID: 17074676 DOI: 10.1007/s12094-006-0124-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Papillar serous carcinoma of peritoneum (PSPC) is an unfrequent neoplasm, histologically similar to papillar serous carcinoma of ovarium. It presents as peritoneal carcinomatosis without evident tumoral focus. Management of PSPC is similar to ovaric neoplasms, although prognosis should be worse. Long-term survival has been described with cytoreductive surgery and adjuvant chemotherapy with platinum. We present hereby 2 cases of PSPC.
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Affiliation(s)
- Jaime Ruiz-Tovar
- Department of general and Digestive Surgery (Dr. Fresneda Moreno), University Hospital Ramón y Cajal, Madrid, Spain.
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Minami T, Nakatani K, Kondo S, Kanayama S, Tsujimura T. Peritoneal serous papillary adenocarcinoma: report of four cases. Intern Med 2005; 44:944-8. [PMID: 16258208 DOI: 10.2169/internalmedicine.44.944] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report four cases of peritoneal serous papillary adenocarcinoma (PSPC), a rare disease; all patients had ascites and high levels of serum CA125. Clinical and radiological examinations could not differentiate the disease from peritoneal metastatic tumors and mesothelioma, and histopathological analysis including immunochemistry on the specimen obtained at laparotomy or laparoscopy was necessary for the diagnosis. One patient lived for 58 months with cytoreductive surgery and chemotherapy, and another is still living after 20 months by chemotherapy alone. In patients with peritoneal tumors of unknown origin and a high level of serum CA125, taking PSPC into consideration in the differential diagnosis, histopathological examination should be performed.
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Affiliation(s)
- Takeshi Minami
- Department of Gastroenterology, Sumitomo Hospital, Osaka, Japan
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