Graniel-Palafox LE, Guerrero-Avendaño G

Language: Spanish
References: 14
Page: 29-35
PDF size: 417.89 Kb.

ABSTRACT

Introduction. Peritoneal carcinomatosis is defined as the seeding and implantation of neoplastic cells in the peritoneal cavity and represents an advanced stage of many tumors that grow in abdominal and pelvic organs. Peritoneal carcinomatosis can and should be identified by sectional imaging methods, and multidetector computed tomography facilitates its characterization and orientation to the primary site.
Material and method. A retrospective, descriptive, and observational study was conducted from December 2010 to July 2012. Fifty-two abdominopelvic tomographic studies were analyzed with a Siemens^® Sensation 64 Slice CT multisection tomograph, and with a Siemens^® Somatom Definition tomograph, in single and contrasted phases.
Results. Fifty-two computed tomography studies were examined in patients with diagnosis of abdominal neoplasm. Fortyone patients were found with malignant ascites, 33 with omental cake, and 15 with transligamentary extension; subdiaphragmatic implants were found in 5 patients and Krukenberg tumors in 2 others.
Discussion. Multisection computed tomography, for diagnosis in patients with peritoneal carcinomatosis, has 41 to 93% sensitivity and 78 to 96% specificity. Between 15 and 50% of patients with cancer develop ascites. Ovarian, breast, endometrial, colon, stomach, pancreatic, and bronchial cancers present the highest incidence. Transligamentary dissemination and omental cake occur due to the close contiguity of the primary tumor with the greater and lesser omenta and their different supporting ligaments, as well as by seeding through peritoneal fluid.
Conclusions. Peritoneal carcinomatosis represents an advanced stage of most abdominal neoplasms and ovarian and gastric cancers are among the most representative. Multidetector computed tomography has good sensitivity and specificity for diagnosis of peritoneal carcinomatosis depending on the clinical stage of the disease.

REFERENCES

1. Levitt Robert G, Sagel Stuart S, Stanley Robert J. Detection of Neoplastic Involvement of the Mesentery and Omentum by Computed Tomography. Am J Roentgenol 1978;131:835-838.

2. Jacquet P, Felinek JS, Steves MA, Sugarbaker PA. Evaluation of Computed Tomography in Patients with Peritoneal Carcinomatosis. Cancer 1993;721:631-6.

3. Motta GA, Torres VE, Zinser SJ, Rodríguez TC, Castillo LJ. Carcinomatosis peritoneal; patrones de imagen por tomografía computarizada multidetector (TCMD). GAMO 2010;9:6.

4. Ciolina M, Baldassari P, Iannitti M, Pichi A, Iafrate F, Laghi A. Imaging of Peritoneal Carcinomatosis with MDCT: spectrum of diagnostic patterns, sites involved and proposal for a new detailed reporting scheme. ESR 2012;10:1594.

5. Nissan A, Stojadinovic A, Garofalo A, Esquivel J, Piso P. Evidence- based medicine in the treatment of peritoneal carcinomatosis: past, present and future. Journal of surgical oncology 2009;100:335-544.

6. Franiel T, Diederichs G, Engelken F, Elgeti T, Rost J, Rogalla P. Multi-detector CT in peritoneal carcinomatosis: diagnos- tic role of thin slices and multiplanar reconstructions. Abdom Imaging 2009;34:49–54.

7. Kusamura S, Baratti D, Zaffaroni N, Villa R, Laterza B, Balestra MR, Deraco M. Pathophysiology and biology of peritoneal carcinomatosis. World J Gastrointest Oncol 2010;15;2(1):12-18.

8. Pannu HK, Bristow RE, Montz FJ, Fishman Elliot K. Multidetector CT of peritoneal carcinomatosis from ovarian cancer. Radiographics 2003;23:687–701.

9. Sheth S, Horton KM, Garland MR, Fishman EK. Mesenteric Neoplasms: CT Appearances of primary and secondary tumors and differential diagnosis. Radio Graphics 2003;23:457–473.

10. Sadeghi B, Arvieux C, Glehen O. Beaujard AC, Rivoire M, Baulieux J. Fontaumard E, Brachet A, Caillot JL, Faure JL, Porcheron J, Peix JL, Francois Y, Vignal J, Gilly FN. Peritoneal Carcinomatosis from Non-Gynecologic Malignancies. American Cancer Society 2000; 88: 358-363.

11. Su JK, Hyung-Ho K, Young HK, Sun H, Hye SL, Do JP, So YK, Kyoung HL. Peritoneal Metastasis: Detection with 16– or 64 –Detector Row CT in Patients Undergoing Surgery for Gastric Cancer. Radiology 2009;253(2):407-405.

12. Levy AD, Shaw JC, Sobin LH. Secondary Tumors and Tumor like Lesions of the Peritoneal Cavity: Imaging Features with Pathologic Correlation. Radio Graphics 2009;29:347–373.

13. Plancarte R, Guillén MR, Guajardo J, Mayer F. Ascitis en los pacientes oncológicos. Fisiopatogenia y opciones de tratamiento. Revista de la Sociedad Española del Dolor 2004;11:156-162.

14. Joon SL, Mi JY, Myeong-Jin K, Woo JH, Mi-Suk P, Jin-Young C, Tae-Sung K, Jong DL, Sung HN, Ki WK. CT and PET in Stomach Cancer: Preoperative Staging and Monitoring of Response to Therapy. Radio Graphics 2006;26:143–156.