Abstract
Introduction
Pseudomyxoma peritonei is an infrequent entity, defined by collections of gelatinous material in the abdomen and pelvis and mucinous implants on peritoneum, secondary to the rupture of a mucinous lesion, usually of ovarian or appendiceal origin.
Materials and methods
We present our experience of 11 cases (6 males and 5 females) diagnosed with pseudomyxoma peritonei secondary to epithelial appendicular neoplasms over 27 years. The mean age of the patients was 68 years. Clinical manifestations were abdominal distension (55%), right lower quadrant pain (45%) suggesting acute appendicitis and constitutional syndrome (36%). An abdominal mass was detected at physical examination in 4 patients. CT scan revealed a tumour in right iliac fossa in 4 patients, peritoneal enlargement in 1 and a liquid collection in 1. Preoperative diagnosis was acute abdomen in 5 patients, peritoneal carcinomatosis in 3 and undetermined abdominal mass in 3.
Results
Surgical findings suggested pseudomyxoma peritonei in 8 patients and peritoneal carcinomatosis in 3. Appendicectomy was performed in 9 patients, and in 3 of them bilateral anexectomy was also performed. One patient underwent ileocaecal resection and another a right hemicolectomy. In all the cases, mucinous material was eliminated as much as possible. Pathology revealed mucinous cystoadenoma in 6 cases, mucinous cystoadenocarcinoma in 3 and epithelial hyperplasia in 2 patients. Median survival was 54 months, with a 5-year survival rate of 40%. The last case we treated was sent to a reference centre for the treatment of pseudomyxoma peritonei.
Conclusions
There is no consensus on the best treatment for pseudomyxoma peritonei. We recommend avoiding incomplete surgical resections in non-reference centres and submitting patients to a reference centre to undergo adequate treatment.
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References
Porrero JL, Morales V, Carda P et al (1998) Pseudomixoma peritoneal. A propósito de 3 casos. Cir Esp 43:135–137.
Hinson FL, Ambrose NS (1998) Pseudomyxoma peritonei. Br J Surg 85:1332–1339
Miner TJ, Shia J, Jaques DP et al (2005) Long-term survival following treatment of pseudomyxoma peritonei: an analysis of surgical therapy. Ann Surg 241:300–308
Sugarbaker PH (2006) New standard of care for appendiceal epithelial neoplasmas and pseudomyxoma peritonei syndrome. Lancet Oncol 7:69–76
Ruiz-Tovar J, Morales V, García-Teruel D et al (2007) Mucocele of the appendix. World J Surg 31:542–548
Sugarbaker PH (1999) Intraperitoneal chemotherapy and cytoreductive surgery: a manual for physicians and nurses, 3rd Edn. Grand Rapids: The Ludann Company
Misdraji J, Yantiss RK, Graem-Cook FM et al (2003) Appendiceal mucinous neoplasms: a clinicopathological analysis of 107 cases. Am J Surg Pathol 27:1089–1103
Sugarbaker PH (2005) Are there surgical options to peritoneal carcinomatosis? Ann Surg 242:748–750
Murphy EM, Sexton R, Moran BJ (2006) Early results of surgery in 123 patients with pseudomyxoma peritonei from a perforated appendiceal neoplasm. Dis Col Rectum 50:37–42
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Ruiz-Tovar, J., Morales Castiñeiras, V., García Teruel, D. et al. Pseudomyxoma peritonei secondary to epithelial appendicular neoplasms. Experience in a non-specialised centre. Clin Transl Oncol 9, 737–741 (2007). https://doi.org/10.1007/s12094-007-0131-3
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DOI: https://doi.org/10.1007/s12094-007-0131-3