[Clinicopathological study of pseudomyxoma peritonei]

Twelve cases of pseudomyxoma peritonei in Kurume University Hospital and its affiliated hospitals were clinicopathologically analysed. The patients were 42 to 81 years old, and the averaged age was 65.1 years. One case was before menopause. As to past history, one had undergone simple hysterectomy for myoma uteri previously, another patient (No. 8) was diagnosed as having mucinous adenocarcinoma of the appendix and two others (cases No. 2 and 7) had had treatment for pleurisy and peritonitis. Histologically, 3 cases were diagnosed as benign, 4 were borderline malignancy, and 5 were frankly malignant. Six cases were cytologically examined. Four of 6 were recognized as malignant cases. It was thought the diagnosis should be done by both cytological and radiological examination. It was suggested by the past history and histological infiltration of inflammatory cells in cases No. 2 and 7 that the histogenesis of pseudomyxoma peritonei was related to the inflammation with mucinous tumors. The relationship between histological findings and prognosis was unclear. Three cases were treated by surgery only, 6 cases by surgery and chemotherapy, and the other 3 cases by surgery, chemotherapy and washing intraperitoneally with dextran. The five year survival rate for cases treated by surgery and chemotherapy was 40.0%, including 2 patients still living more than 10 years later. All three cases treated by washing intraperitoneally with dextran survived, but for less than 5 years. The result of treatment by washing with dextran was thought to be an effective therapy for pseudomyxoma peritonei.