Pseudomixoma peritonei, a rare entity difficult to diagnose and treat - case report

The authors present the case of a 56 year-old patient diagnosed with pseudomyxoma peritonei, 4 years after being subjected to a left adnexectomy for ovarian cystadenoma. The intra-parietal insemination of the mucinous cells enabled the development,at this level, of a gelatinous mass that raised problems of differential diagnosis with irreducible incisional hernia. In what regards the preoperative signs of clinical and paraclinical diagnosis we consider them obscure and nonspecific. The abdominal computed tomography revealed the presence of a massive intraperitoneal collection, but given the rarity of this pathology the initial diagnosis was made in the course of the exploratory laparotomy. Intraoperatively it became necessary to perform the omentectomy and total hysterectomy with contralateral adnexectomy and appendectomy. The histopathological examination confirmed the diagnosis. Using cisplatin associated with aggressive surgical cytoreduction this case of pseudomixoma had a good long-term evolution. The diagnosis was a challenge, and the nonspecific slow evolution of the disease led to difficult differential diagnostic.