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Primary peritoneal carcinoma presenting as adenocarcinoma on a Pap smear. A case report
Jason D Wright1, Neil S Horowitz, Janet S Rader
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA. wrightj@msnotes.wustl.edu
Background:
Primary peritoneal carcinoma is an uncommon malignancy that usually presents with gastrointestinal symptoms from abdominal carcinomatosis.
Case:
A postmenopausal woman presented with vaginal bleeding and adenocarcinoma cells on a Pap smear. Colposcopy, endocervical and endometrial curettage, mammography, colonoscopy and pelvic ultrasound were all normal. Computed tomography revealed a large omental cake and ascites, and the CA-125 level was elevated, 2,907 IU/mL. Exploratory laparotomy revealed a primary peritoneal carcinoma with abdominal carcinomatosis.
Conclusion:
Primary peritoneal carcinoma should be considered in the differential diagnosis of adenocarcinoma cells arising on a Pap smear in the absence of cervical and endometrial cancer.