Abstract
Primary peritoneal serous papillary carcinoma (PPSPC) is a rare primary tumor of the peritoneum that found predominantly in elderly and post-menopausal women. The aim of our study is to review the clinical and pathologic information of 22 patients, and then try to summarize clinical behavior and pathological characteristics of PPSPC, in order to be better recognized of this entity in future. We retrospectively reviewed the data from 22 patients with PPSPC treated at our hospital from 1992 to 2008. All paraffin blocks were recut for periodic acid-Schiff diastase and immunohistochemical staining for CD15, cytokeratin7(CK7), cytokeratin20(CK20), S-100 protein, carcinoembryonic antigen (CEA), CA125, estrogen receptor(ER) and progesterone receptor(PR). The median age of the patients at the time of surgical staging was 56 years (range, 32–77 years). The most common presenting symptoms were abdominal distension (59.1%) and ascites (63.6%). Pretreatment CA125 levels were significant elevated in 90.5% patients. Optimal debulking was performed in 18 patients. All patients were consequently treated with platinum-based chemotherapy. Response to treatment is promising, and the median overall survival of all patients was 21.0 months (95% CI 16.9, 25.1 months). The positive rate of immunohistochemical staining was CD15 95.5%, CK7 90.9%, S-100 protein 68.2%, CA125 59.1%, CK20 31.8%, ER 31.8%, CEA 27.3% and PR 9.1%, respectively. Gynecologist should be aware of PPSPC when abdominal distension, gross ascites and a raised level of CA125 in women without ovarian enlargement. Immunohistochemical staining might be helpful as accessory criteria for the differential diagnosis among the PPSPC, peritoneal malignant mesothelioma (PMM), primary epithelial ovarian carcinoma (PEOC) and peritoneal carcinomatosis from the gastrointestinal tumors (SPCGT). Cytoreductive surgery combined with pre/postoperative platinum-based chemotherapy may be effective for PPSPC patients.
Similar content being viewed by others
References
Swerdlow M (1959) Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary. Am J Obstet Gynecol 77:197–200
Bloss JD, Liao SY, Buller RE et al (1993) Extraovarian peritoneal serous papillary carcinoma: a case-control retrospective comparison to papillary adenocarcinoma of the ovary. Gynecol Oncol 50(3):347–351
Fox H (1993) Primary neoplasia of the female peritoneum. Histopathology 23:103–110
Jaaback KS, Ludeman L, Clayton NL et al (2006) Primary peritoneal carcinoma in a UK cancer center: comparison with advanced ovarian carcinoma over a 5-year period. Int J Gynecol Cancer 16(1):123–128
Choi CH, Kim TJ, Kim WY et al (2007) Papillary serous carcinoma in ovaries of normal size: a clinicopathologic study of 20 cases and comparison with extraovarian peritoneal papillary serous carcinoma. Gynecol Oncol 105(3):762–768
Tews G, Fiedler T, Ebner T (2004) Primary peritoneal carcinoma. J Am Assoc Gynecol Laparosc 11(3):289–290
Eltabbakh GH, Piver MS, Natarajan N et al (1998) Epidemiologic differences between women with extraovarian primary peritoneal carcinoma with women with epithelial ovarian cancer. Obstet Gynecol 91:254–259
Jordan SJ, Green AC, Whiteman DC et al (2008) Serous ovarian, fallopian tube and primary peritoneal cancers: a comparative epidemiological analysis. Int J Cancer 122(7):1598–1603
Halperin R, Zehavi S, Langer R et al (2001) Primary peritoneal serous papillary carcinoma: a new epidemiologic trend? A matched-case comparison with ovarian serous papillary cancer. Int J Gynecol Cancer 11:403–408
Altras MM, Aviram R, Cohen I et al (1991) Primary peritoneal papillary serous adenocarcinoma: clinical and management aspects. Gynecol Oncol 40:230–236
Zhou J, Iwasa Y, Konishi I et al (1995) Papillary serous carcinoma of the peritoneum in women. A clinicopathologic and immunohistochemical study. Cancer 76:429–436
Wang M, Zhang TG, Xu C et al (1999) Diagnosis and differential diagnosis of primary carcinoma of female peritoneum. Chin J Pathol 28(1):16–19
Sheibani K, Battifora H, Burke JS (1986) Antigenic phenotype of malignant mesotheliomas and pulmonary adenocarcinomas. An immunohistologic analysis demonstrating the value of Leu M1 antigen. Am J Pathol 123(2):212–219
Ordonez NG (1998) Role of immunohistochemistry in distinguishing epithelial peritoneal mesotheliomas from peritoneal and ovarian serous carcinomas. Am J Surg Pathol 22:1203–1214
Khoury N, Raju U, Crissman JD et al (1990) A comparative immunohistochemical study of peritoneal and ovarian serous tumours and mesotheliomas. Hum Pathol 21:811–819
von Riedenauer WB, Janjua SA, Kwon DS et al (2007) Immunohistochemical identification of primary peritoneal serous cystadenocarcinoma mimicking advanced colorectal carcinoma: a case report. J Med Case Rep 1:150–155
Attanoos RL, Webb R, Dojcinov SD et al (2002) Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum. Histopathology 40:237–244
Gitsch G, Tabery U, Feigl W et al (1992) The differential diagnosis of primary peritoneal papillary tumors. Arch Gynecol Obstet 251(3):139–144
Ruiter DJ, Brocker E-B (1993) Immunohistochemistry in the evaluation of melanocytic tumors. Semin Diagn Pathol 10:76–91
Michael JD (2001) Carcinoembryonic Antigen as a Marker for Colorectal Cancer: Is It Clinically Useful? Clin Chem 47(4):624–630
Lee BH, Hecht JL, Pinkus JL et al (2002) WT1, estrogen receptor, and progesterone receptor as markers for breast or ovarian primary sites in metastatic adenocarcinoma to body fluids. Am J Clin Pathol 117:745–750
Barnetson RJ, Burnett RA, Downie I et al (2006) Immunohistochemical analysis of peritoneal mesothelioma and primary and secondary serous carcinoma of the peritoneum: antibodies to estrogen and progesterone receptors are useful. Am J Clin Pathol 125(1):67–76
Halperin R, Zehavi S, Hadas E et al (2001) Immunohistochemical comparison of primary peritoneal and primary ovarian serous papillary carcinoma. Int J Gynecol Pathol 20:341–345
Nam JH, Kim YM, Jung MH et al (2006) Primary peritoneal carcinoma: experience with cyto reductive surgery and combination chemotherapy[J]. Int J Gynecol Cancer 16(1):23–28
Tohya T, Ujioka T, Yamaguchi M (2008) Successful treatment of primary peritoneal carcinoma with paclitaxel and carboplatin combination chemotherapy. Gan To Kagaku Ryoho 35(1):153–155
Kennedy AW, Markman M, Webster KD et al (1998) Experience with platinum-paclitaxel chemotherapy in the initial management of papillary serous carcinoma of the peritoneum. Gynecol Oncol 72(1):288–290
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Liu, Q., Lin, Jx., Shi, Ql. et al. Primary Peritoneal Serous Papillary Carcinoma: A Clinical and Pathological Study. Pathol. Oncol. Res. 17, 713–719 (2011). https://doi.org/10.1007/s12253-011-9375-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12253-011-9375-x