Benign multicystic peritoneal mesothelioma mimicking mucinous ovarian neoplasm with pseudomyxoma peritonei

Taşlıçay, Ceylan Altıntaş; Asadullayeva, Maila; Civriz, Aziz Hakki; Pösteki, Gökhan

doi:10.1136/bcr-2022-254116

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…The variation in the types of lesions that might mimic a mucinous ovarian neoplasm with pseudomyxoma peritonei is broad, and it also includes a benign multicystic peritoneal mesothelioma, as explained by Altintas Taslicay [53]. Another clinical and pathological (differential) diagnosis is the one made with a ruptured primary mucinous cystadenoma of the spleen leading to mucinous ascites, as explained by Gupta [54].…”

Section: Imaging Findings Diagnosis and Differential Diagnosismentioning

confidence: 99%

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Ionescu,

Marincas,

Madge

et al. 2024

Cancers

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Background. Pseudomyxoma peritonei (PMP) is a rare, progressive, slowly growing, inadequately understood neoplasm with a 5-year progression-free survival rate of as low as 48%. It is characterized by varying degrees of malignancy and the production of mucinous and gelatinous structures. Typically, the development of pseudomyxoma peritonei is associated with the rupture of appendiceal mucinous tumors and other gastrointestinal or ovarian mucinous tumors. The goal of our literature review was to identify various aspects that characterize the ovarian causes of pseudomyxoma peritonei. Materials and methods. The authors performed an extensive literature search between 1 February 2024 and 2 March 2024 on the following databases: Pubmed, Scopus, Oxford Journals, and Reaxys, and the findings were summarized into seven main clinical and paraclinical situations. Results. According to our research, the main instances in which pseudomyxoma peritonei can be triggered by an ovarian cause are the following: (1) mucinous cystadenoma; (2) mucinous ovarian cancer; (3) colon cancer with ovarian metastasis; (4) malignant transformation of an ovarian primary mature cystic teratoma; (5) appendiceal mucocele with peritoneal dissemination mimicking an ovarian tumor with peritoneal carcinomatosis; (6) mucinous borderline tumor developing inside an ovarian teratoma; and (7) the association between a mucinous bilateral ovarian cancer and a colonic tumor. Conclusions. In our study, we aimed to provide a comprehensive overview of the ovarian causes of pseudomyxoma peritonei, including its epidemiology, imagery characteristics, symptoms, current treatment, and promising future therapies, in the hopes of finding feasible solutions, as a lack of understanding of this mucus-secreting malignant disease increases the risk of delayed diagnosis or uncontrolled deterioration.

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Section: Imaging Findings Diagnosis and Differential Diagnosismentioning

confidence: 99%

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Ionescu,

Marincas,

Madge

et al. 2024

Cancers

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Large and Extensive Multilocular Peritoneal Inclusion Cysts Lack Genomic Alterations and Follow an Indolent Clinical Course Despite Rare Recurrences

Devins,

Baranov,

Hung

et al. 2024

American Journal of Surgical Pathology

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Peritoneal inclusion cysts (PICs) are unilocular or multilocular cystic lesions lined by bland mesothelial cells. While most are small and localized, rare examples may be large or multifocal with diffuse peritoneal involvement, causing clinical and even pathologic concern for malignancy. We examined 20 PIC, including 8 large solitary and 12 multifocal lesions. Solitary PIC were found in 7 female and 1 male patients ranging from 19 to 55 (median: 37) years. Expanded collagenous (n=2) or edematous (n=1) areas were occasionally seen in the septae, and 1 had microscopic foci of myxoid stroma. Four had hobnail cells, and 1 had minor areas of papillary mesothelial hyperplasia. Multifocal PICs occurred in 9 female and 3 male patients ranging from 26 to 80 (median: 53) years. Three showed extensive associated fibrosis with entrapment of preexisting adipose tissue, 2 had areas resembling granulation tissue, and 3 had scattered foci of myxoid stroma. Hobnail cells were present in 9, papillary mesothelial hyperplasia in 2, entrapped single cells in 1, and 2 had areas resembling adenomatoid tumors. Two of the multifocal PICs had limited local recurrences at 18 and 21 months. No patients died of disease. Clonal alterations were not identified in any of the tested PICs (mutational and fusion analysis in 5, chromosomal microarray in 1). Despite limited local recurrences, we demonstrate that even large and multifocal PICs may lack identifiable genomic alterations and are associated with benign outcomes.

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Analysis of therapeutic effect of cell reduction combined with intraperitoneal thermoperfusion chemotherapy in treatment of peritoneal pseudomyxoma

Li,

Ru,

Xuan

et al. 2024

World J Gastrointest Surg

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BACKGROUND Pseudomyxoma peritonei is a rare tumor that can produce a biological behavior similar to that of a malignant tumor. Surgical resection combined with chemotherapy is the traditional treatment method, but the effect is not good. Cell reduction (CRS) combined with intraperitoneal thermoperfusion chemotherapy (HIPEC) has become a new method for the treatment of peritoneal pseudomyxoma (PMP). AIM To find out if CRS and HIPEC can be used safely and effectively to treat PMP. METHODS This is an observational study. Clinical data of PMP patients treated with CRS + HIPEC at our hospital from January 2013 to June 2023 was collated and analyzed. The main outcome measures were overall survival (OS), and the secondary outcome measures were the incidence of surgical complications and serious adverse events. Complications were graded according to common adverse event evaluation criteria. Peritoneal tumor staging was performed using the peritoneal tumor index (PCI) scoring system, and a cell reduction degree (CCR) score was performed after CRS. CCR-0 and CCR-1 were considered satisfactory CRS. RESULTS A total of 186 patients with PMP were included, with a median age of 56 (48-64) years, 65 (34.9%) years in males, and 121 (65.1%) years in females. The median PCI score was 28 (20-34) points. The median operative time was 300 (211-430) minutes, and no significant complications occurred. 91.4% (170/186) were from the appendix, 53.2% (99/186) were from the low grade, and 30.6% (57/186) were from the high grade. CCR scores showed that 55 patients (29.6%) achieved satisfactory CRS, and 113 patients (60.8%) did not achieve satisfactory CRS. The fatality rate at 30 days after surgery was 2.7% (5/186), 1.6% (3/186) needed a second operation, and the fatality rate at 90 days was 4.3% (8/186). The total incidence of III-IV complications was 43.0% (80/186), among which the higher incidence was mainly anemia (27.4%, 51/186), electrolyte disturbance (11.6%, 21/181), and albumin decrease (7.5%, 14/186). The main complications associated with abdominal surgery were gastrointestinal anastomotic leakage (2.2%, 4/186), abdominal hemorrhage (2.2%, 4/186), and abdominal infection (4.3%, 8/186). The median follow-up was 38.1 (95%CI: 31.2-45.1) months. The 5-year OS of PMP patients treated with CRS + HIPEC was 50.3% (95%CI: 40.7%-59.9%), and the median survival time was 66.1 (95%CI: 43.1-89.1) months. The results of the survival analysis showed that patients with a low pathological grade, a low PCI, and a satisfactory CCR score had a higher survival rate (all P < 0.05). 5-year OS was 88.9% (95%CI: 68.3%-100.0%) in CCR-0 patients, 77.6% (95%CI: 62.7%-92.5%) in CCR-1 patients, and 42.0% (95%CI: 29.5%-54.5%) in CCR-2/3 patients. CONCLUSION The application of CRS + HIPEC in PMP is safe and feasible, and the survival benefit is high, especially in those who achieve satisfactory CRS, which can significantly extend the OS.

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Benign multicystic peritoneal mesothelioma mimicking mucinous ovarian neoplasm with pseudomyxoma peritonei

Cited by 3 publications

References 13 publications

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Large and Extensive Multilocular Peritoneal Inclusion Cysts Lack Genomic Alterations and Follow an Indolent Clinical Course Despite Rare Recurrences

Analysis of therapeutic effect of cell reduction combined with intraperitoneal thermoperfusion chemotherapy in treatment of peritoneal pseudomyxoma

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