Villazón Ó, Álvarez MM, Ávila A, Cruz O, Mauricio H, Cartagena E

Language: Spanish
References: 11
Page: 170-174
PDF size: 116.07 Kb.

ABSTRACT

Introduction: Pseudomyxoma peritoneal was first described by Werth in 1884. In 1901 Frankel described a case associated with an apendicular cyst. Is a rare disease, that represents a diagnostic challenge, it is characterized by disseminated mucinous ascites and peritoneal implants. With an incidence of 1 to 2 per million a year. It is commonly seen in women, related to an underlying ovarian lesions, or apendicular adenocarcinomas. Case report: A 63 year old female that begins a month prior to admission, after routine gynecological consult, where specialist performed an abdominal ultrasonography, visualizing free fluid in abdominal cavity, the patient was asymptomatic at the present time, she was referred to general surgery. Tomography computerized the presence of multiple peritoneal implants associated with a large amount of intra-abdominal ascites. At laparoscopy multiple epiploic infiltrations of mucinoid material was found, and biopsies from the hepatic capsule and greater omentum were taken, apendectomy was performed due to high suspicion of neoplasia. The pathology report was mucinoid cistadenocarcinoma of the appendix; liver with focal and mild intracitoplasmic cholestasis, no fibrosis or neoplasic infiltrations. Omentum with multifocal glandular epithelium with mucus, and chronic and acute focal and inespecific inflammation, as reactive mesothelial hyperplasia; peritoneal pseudomyxoma well differentiated. Clinical oncology was consulted, who agrees that the best treatment is extensive cytoreductive surgery followed by intra-peritoneal chemotherapy with cisplatin. Cytoreduction of pseudomyxoma was performed by laparotomy, performing cholecystectomy, resection of omentum and falciform ligament with placement of peritoneal Tenckhoff catheter for chemotherapy. Conclusions: Pseudomyxoma peritoneal is a rare disease most commonly seen in women. Most of the cases originate from ovarian tumors, it has been found an increase of appendiceal origin. Is a neoplastic disease expressing goblet cells expressing MUC-2. Appendiceal mucinous tumors also express MUC-2, which can differentiate if the origin is appendicular or ovarian cancer. Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy allows complete tumor resection.

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