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The many faces of pseudomyxoma peritonei: a radiological review based on 30 cases
Cássia Fonseca1, Saulo Carvalho1, Teresa Margarida Cunha1
1Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
Objective:
To determine the most common imaging features of pseudomyxoma peritonei (PMP), as well as the histologic subtypes of the primary tumors.
Materials And Methods:
We reviewed 30 cases of women with pathologically confirmed PMP. Only computed tomography scans were available. All cases were retrospectively studied by four radiologists, working independently. We identified the most common imaging findings, the predominant primary site of the disease, and the growth pattern. The most common sites of recurrence were also analyzed.
Results:
The most common computed tomography finding was peritoneal/omental nodules (including "omental caking"), followed by visceral scalloping and non-mucinous ascites. The most common site of the primary tumor was the appendix (in 63.3%), followed by the ovaries (in 16.6%), and 16.6% of the tumors were of undetermined origin. There was one case of synchronous appendiceal and ovarian tumors. Low-grade mucinous neoplasm was the most common histologic subtype, accounting for 84.2% of the appendiceal tumors and 40% of the ovarian tumors.
Conclusion:
Although PMP is a relatively rare entity, radiologists must be aware of its possible imaging findings, common locations, and possible patterns of recurrence. The origin of the primary tumor should also be investigated. Future studies are needed in order to determine which preoperative imaging findings predict surgical outcomes and to characterize the main findings of radiological recurrence.
Insights
Pseudomyxoma peritonei (PMP) often presents as peritoneal/omental nodules and visceral scalloping on CT scans. The appendix is the most common primary tumor site, frequently a low-grade mucinous neoplasm.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Pseudomyxoma peritonei (PMP) is a rare condition characterized by mucinous ascites and implants.
- Accurate diagnosis relies on identifying characteristic imaging features and primary tumor histology.
Purpose of the Study:
- To identify common computed tomography (CT) imaging features of PMP.
- To determine the most frequent primary tumor sites and histologic subtypes in PMP.
Main Methods:
- Retrospective review of 30 pathologically confirmed PMP cases in women.
- Analysis of computed tomography (CT) scans by four independent radiologists.
- Identification of common imaging findings, primary tumor sites, and recurrence patterns.
Main Results:
- Peritoneal/omental nodules and visceral scalloping were the most common CT findings.
- The appendix was the most frequent primary tumor site (63.3%), followed by the ovaries (16.6%).
- Low-grade mucinous neoplasm was the predominant histologic subtype.
Conclusions:
- Radiologists should recognize PMP's imaging features, common origins (especially the appendix), and recurrence patterns.
- Further research is needed to correlate preoperative imaging with surgical outcomes and recurrence characteristics.
