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Interventional radiology strategies in the treatment of pseudomyxoma peritonei
Eric vanSonnenberg1, Brian W Goodacre, Gerhard R Wittich
1Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA. ericvansonnenberg@yahoo.com
Purpose:
To describe percutaneous maneuvers to treat the unusual entity symptomatic pseudomyxoma peritonei (PMP).
Methods:
Four patients with PMP were treated by interventional radiology techniques that included large catheters (20-30 Fr) alone (n = 3), multiple catheters (n = 4), and dextran sulfate as a catalytic agent through smaller catheters (n = 1). The causes of the PMP were tumors in the ovary (2 patients), appendix (1 patient), and colon (1 patient). Each patient previously had undergone at least two operations to remove the PMP, and all patients had symptomatic recurrence. An in vitro analysis of catalytic agents also was performed.
Results:
All four patients improved symptomatically. Follow-up CT scans demonstrated marked reduction of PMP material in all cases. One patient underwent another interventional radiology session 5 months after the first; the other three patients had no recurrence of symptoms. One patient had reversible hypotension 2 hr after the procedure. The amount of material removed varied from 3 to 6 L.
Conclusion:
These interventional radiology techniques were effective and safe for PMP and suggest options for this difficult medical and surgical problem.