[Serous papillary cancer of the peritoneum: a multicentric primary disease]

Protocols and histologic slides of 258 patients who underwent surgery for the diagnosis of an ovarian carcinoma from 1980 to 1987 at the University Hospital Charlottenburg/Berlin and from 1987 to 1990 at the I. University Women's Hospital Munich were reexamined. 12 out of 165 patients with a serous carcinoma were classified under the diagnosis of a peritoneal serous papillary carcinoma with minimal or absent ovarian involvement. These cases could be differentiated from patients with primary serous ovarian carcinomas by the sole existence of progressed FIGO stages. Especially the picture of small disseminated nodes could be seen. The excessive involvement of pelvic and paraaortic lymph nodes was impressive as well. The peritoneal carcinomatosis consisting of small nodes in our opinion could best be explained by in situ orthotopic multifocal growth. We were able to prove the in-situ genesis of these lesions in 6 of 12 cases by histologic examination. In this group of patients with peritoneal primary serous carcinoma we find the example for a multifocal disease originating from the coelomic epithelium.