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Published on: December 9, 2022
Incidental Diagnosis of Pseudomyxoma Peritonei: A Case Report
Giuseppe Sarpietro1, Marco Iraci Sareri1, Giulia Maria Bonanno1
1General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, Catania, ITA.
Abstract:
Pseudomyxoma peritonei (PMP) is a rare clinical condition characterized by disseminating gelatinous ascites within the peritoneal cavity with mucinous implants on peritoneal surfaces. We present the case of a patient incidentally diagnosed after laparoscopy: definitive diagnosis after the histological examination was PMP. A 37-year-old female patient with a medical history of infertility and mild pelvic pain was found to have several collections in the pelvis and an amount of free fluid into the Douglas pouch at ultrasound examination. The patient underwent laparoscopic surgical exploration. Peritoneal biopsies and appendectomy were performed. Histological examination was about a low-grade appendiceal mucinous tumor limited to the mucosa without submucosal infiltration with perforation of the wall and deposit of periappendicular acellular mucin. The patient was discharged in good health and referred to an oncological peritoneal center where cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) were performed. In conclusion, PMP is an uncommon disease within the abdomen, characterized by a mucinous tumor that produces progressive mucinous ascites. It is characterized by various non-specific symptoms and signs and difficult imaging diagnoses. Histological diagnosis is a determinant to establish the therapy that can differ significantly, depending on the stage of the disease.
Insights
Pseudomyxoma peritonei (PMP) is a rare condition of gelatinous ascites. Early diagnosis via histology is crucial for effective treatment, often involving cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Pseudomyxoma peritonei (PMP) is a rare condition characterized by mucinous ascites and peritoneal implants.
- It often presents with non-specific symptoms and can be challenging to diagnose via imaging.
Observation:
- A 37-year-old female with infertility and pelvic pain was incidentally diagnosed with PMP post-laparoscopy.
- Ultrasound revealed pelvic fluid collections; laparoscopy confirmed PMP with peritoneal biopsies and appendectomy.
Findings:
- Histological examination revealed a low-grade appendiceal mucinous tumor limited to the mucosa with perforation and mucin deposit.
- This confirmed the PMP diagnosis, leading to referral for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
Implications:
- Histological diagnosis is critical for determining appropriate PMP treatment strategies.
- PMP management requires specialized oncological care, often involving multimodal therapy like CRS and HIPEC.
