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Mucinous Appendiceal Neoplasms and Pseudomyxoma Peritonei: Imaging Features and Current Therapies

Laura C Jorgenson1, Sherry S Wang1, Travis E Grotz1

  • 1From the Department of Radiology (L.C.J., S.S.W., P.J.N., C.F., S.K.V., J.L.F., J.G.F., E.C.E., S.P.S.), Department of Surgery, Division of Hepatobiliary and Pancreas Surgery (T.E.G.), and Department of Laboratory Medicine and Pathology (R.P.G.), Mayo Clinic, 200 1st St SW, Rochester, MN 55905.

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|May 29, 2025
PubMed

Insights

This review clarifies mucinous appendiceal neoplasms and pseudomyxoma peritonei (PMP) for radiologists, detailing imaging strategies and disease patterns. Understanding these aspects is crucial for effective treatment and surgical planning in PMP management.

Area of Science:

  • Gastrointestinal Radiology
  • Oncologic Imaging
  • Abdominal Imaging

Background:

  • Pseudomyxoma peritonei (PMP) arises from mucinous appendiceal neoplasms, characterized by gelatinous peritoneal metastases.
  • Standard treatment involves cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, but recurrence rates remain high.
  • Novel therapeutic strategies are under investigation due to common recurrence patterns.

Purpose of the Study:

  • To enhance radiologists' comprehension of mucinous appendiceal neoplasms and PMP.
  • To provide insights into nomenclature, pathophysiology, and imaging strategies for these conditions.
  • To highlight imaging findings impacting cytoreduction and surgical decisions.

Main Methods:

  • Comprehensive literature review focusing on imaging of mucinous appendiceal neoplasms and PMP.
  • Analysis of nomenclature, pathophysiology, and diagnostic imaging modalities.
  • Inclusion of a surgical perspective on managing PMP.

Main Results:

  • Detailed description of the typical imaging appearance of mucinous appendiceal neoplasms and peritoneal disease.
  • Identification of disease areas that complicate complete cytoreduction.
  • Discussion of imaging's role in surgical planning and decision-making.

Conclusions:

  • Accurate radiologic interpretation of mucinous appendiceal neoplasms and PMP is vital for patient management.
  • Understanding imaging pitfalls is essential for optimizing surgical outcomes.
  • This review provides a multidisciplinary approach to PMP, integrating radiology and surgical insights.

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