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Culture and Imaging of Ex Vivo Organotypic Pseudomyxoma Peritonei Tumor Slices from Resected Human Tumor Specimens
Published on: December 9, 2022
Pulmonary metastasis from pseudomyxoma peritonei
1Department of Surgery, Kishiwada City Hospital, 1001 Gakuhara-cho, Kishiwada, Osaka 5968501, Japan.
Abstract:
Pseudomyxoma peritonei (PMP) is a rare clinical condition, where copious mucinous ascites accumulate in the peritoneal cavity due to dissemination of mucin-producing tumor. Because of this disseminating, yet nonmetastasizing, behavior, PMP attracts much interest from surgical oncologists in that aggressive locoregional therapy can give the opportunity of long survival and even cure. Although extra-abdominal metastasis is exceptionally rare, the lung is the most likely site in such a case. In this paper, the clinical findings and treatment of eleven cases with pulmonary metastasis from PMP were reviewed, including ten cases in the literature and one case which we experienced. The clinical features of PMP cases with pulmonary metastasis were similar to cases without pulmonary metastasis. The histological type was low-grade mucinous neoplasm in most cases. Pulmonary lesions were resected in seven cases in which abdominal lesions were controlled by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy or another therapeutic modality. Disease-free state was maintained in five cases at the end of the follow-up period. However, it should be noted that rapid progression after resection was seen in two cases, suggesting that biological features may have changed by surgical intervention.
Insights
Pseudomyxoma peritonei (PMP) is a rare condition characterized by mucinous ascites. Pulmonary metastasis from PMP, though rare, can be managed with surgical resection, offering long-term survival in some patients.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pseudomyxoma peritonei (PMP) is a rare condition involving mucinous ascites due to mucin-producing tumors.
- PMP's unique disseminating yet non-metastasizing behavior makes it a focus for surgical oncologists.
- Lung is the most common site for extra-abdominal metastasis in PMP.
Purpose of the Study:
- To review clinical findings and treatment outcomes of PMP with pulmonary metastasis.
- To analyze the efficacy of surgical resection for pulmonary lesions in PMP patients.
Main Methods:
- Review of eleven cases of pulmonary metastasis from PMP (10 literature, 1 case experience).
- Analysis of clinical features, histological types, and treatment modalities.
- Evaluation of outcomes following surgical resection of pulmonary lesions.
Main Results:
- Clinical features of PMP with pulmonary metastasis were similar to those without.
- Low-grade mucinous neoplasm was the predominant histological type.
- Seven patients underwent resection of pulmonary lesions; five achieved a disease-free state post-operatively.
- Two cases showed rapid progression after resection, suggesting potential biological changes.
Conclusions:
- Pulmonary metastasis from PMP is rare but manageable with surgical intervention.
- Aggressive locoregional therapy, including cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, is crucial for PMP.
- Surgical resection of pulmonary lesions can lead to long-term survival and cure in select PMP patients.
- Further research is needed to understand biological changes post-surgery.
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