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Published on: March 11, 2014
Low grade peritoneal mucinous carcinomatosis associated with human papilloma virus infection: case report
Zoran Gatalica1, Jason M Foster, Brian W Loggie
1Department of Pathology, Creighton University Medical Center, 601 N 30th St., Omaha, NE 68131, USA. zorangatalica@creighton.edu
Abstract:
Pseudomyxoma peritonei is a clinical syndrome characterized by peritoneal dissemination of a mucinous tumor with mucinous ascites. The vast majority of the pseudomyxoma peritonei are associated with mucinous neoplasms of the appendix. We describe a case of pseudomyxoma peritonei associated with mucinous adenocarcinoma of the cervix in a 60-year-old woman. The patient developed low grade mucinous peritoneal carcinomatosis 8 years after hysterectomy for cervical adenocarcinoma. No other primary mucinous tumor was identified and peritoneal carcinomatosis tested positive for high-risk human papilloma virus (HPV), showing both integrated and episomal pattern. HPV has been previously associated with development of cervical carcinomas (both squamous and mucinous) but neither has cervical adenocarcinoma nor HPV been implicated in development of pseudomyxoma peritonei. To the best of our knowledge, this is the first description of HPV-associated malignancy presenting as pseudomyxoma peritonei.
Insights
Pseudomyxoma peritonei, typically from the appendix, was linked to cervical cancer in a rare case. This study highlights a novel association between human papillomavirus (HPV) and this rare malignancy.
Area of Science:
- Gynecologic Oncology
- Oncology
- Pathology
Background:
- Pseudomyxoma peritonei (PMP) is a rare condition characterized by mucinous ascites and peritoneal tumor spread, most commonly originating from appendiceal neoplasms.
- The etiology of PMP is typically linked to mucinous adenocarcinomas, predominantly of appendiceal origin.
Observation:
- This report details a unique case of PMP in a 60-year-old woman presenting as low-grade mucinous peritoneal carcinomatosis eight years post-hysterectomy for cervical adenocarcinoma.
- Extensive investigation excluded other primary mucinous tumors, and the peritoneal carcinomatosis was confirmed to be positive for high-risk human papillomavirus (HPV), exhibiting both integrated and episomal patterns.
Findings:
- This case represents the first documented instance of pseudomyxoma peritonei associated with a human papillomavirus (HPV)-positive cervical adenocarcinoma.
- The findings challenge the established understanding of PMP origins and suggest a potential role for HPV in the development of PMP in specific gynecologic malignancies.
Implications:
- This discovery broadens the spectrum of known causes for pseudomyxoma peritonei.
- It underscores the importance of considering HPV-driven gynecologic cancers in the differential diagnosis of PMP, even in the absence of a clear appendiceal primary.
- Further research is warranted to explore the oncogenic pathways linking HPV to PMP development.
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