CT imaging review of uncommon peritoneal-based neoplasms: beyond carcinomatosis

Pickhardt, Perry J.; Pérez, Alejandro; Elmohr, Mohab M.; Elsayes, Khaled M.

doi:10.1259/bjr.20201288

Cited by 9 publications

(3 citation statements)

References 30 publications

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“…It is generally reported that PMP peritoneal implants are cystic lesions (17,18). However, one case report showed that PMP could also manifest as a cystic-solid mass (19).…”

Section: Discussionmentioning

confidence: 99%

Enhanced computed tomography imaging features predict tumor grade in pseudomyxoma peritonei

Sun¹,

Li²,

Wang³

et al. 2022

Quant Imaging Med Surg

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Background: Because few studies have focused on the correlation between computed tomography (CT) signs and tumor grade in pseudomyxoma peritonei (PMP), we evaluated predictive value of abdominal enhanced CT in identifying high-vs. low-grade cases.Methods: In all, 75 patients diagnosed with PMP after surgery were consecutively recruited. The preoperative enhanced CT images were retrospectively analyzed for ascites, hepatic scalloping, omental and peritoneal lesion appearance, intralesional calcification and septa, and peripheral organ involvement. Logistic regression models were applied to analyze the relationship of CT signs with PMP grade. Receiver operating characteristic curves were generated to evaluate the potential utility of CT signs in detecting high-grade PMP.Results: Massive ascites (P=0.017) and peritoneal solid nodules (P<0.001) were more common in highgrade cases. Multivariate logistic regression identified massive ascites [odds ratio (OR) =4.389, 95% confidence interval (CI): 1.210-15.921; P=0.025] and peritoneal solid nodules (OR =19.932, 95% CI: 3.560-111.596; P<0.001) as independent predictors of high-grade PMP. For the 55 patients with hepatic scalloping, the maximum thickness of mucin deposition at the hepatic scalloping wave in high-grade PMP was thinner than that in low-grade PMP (P=0.021). Thickness of mucin deposition at the hepatic scalloping wave (OR =0.346, 95% CI: 0.148-0.809; P=0.014) was an independent predictor of high-grade PMP, with a cutoff value of 18.6 mm. Cancer antigen 125 (CA125) combined with CT signs was significantly better at diagnosing high-grade PMP than was CA125 alone in both the overall patients [area under the ROC curve (AUC): 0.812 vs. 0.656; P=0.020] and those with hepatic scalloping (AUC: 0.859 vs. 0.600; P=0.007). Conclusions:The CT signs of high-grade PMP significantly differ from those of low-grade PMP, and thus combining CT signs with CA125 may be highly valuable for classifying PMP.

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“…It is generally reported that PMP peritoneal implants are cystic lesions (17,18). However, one case report showed that PMP could also manifest as a cystic-solid mass (19).…”

Section: Discussionmentioning

confidence: 99%

Enhanced computed tomography imaging features predict tumor grade in pseudomyxoma peritonei

Sun¹,

Li²,

Wang³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…For patients with suspected PeM, the NCCN Guidelines for Mesothelioma: Peritoneal recommend an initial evaluation including (1) CT with contrast of the chest, abdomen, and pelvis; (2) biopsies of the nodule/mass using a midline laparoscopy; and (3) serum markers. 21,42,43 Pathology Tissue biopsy of the abdominal mass/nodule(s) with histopathology is essential for an accurate diagnosis of PeM, because symptoms, imaging findings, and serum markers are not specific. Patients may have benign and preinvasive mesothelial tumors such as peritoneal inclusion cyst, welldifferentiated papillary mesothelial tumor, or mesothelioma in situ.…”

Section: Initial Evaluationmentioning

confidence: 99%

Mesothelioma: Peritoneal, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology

Ettinger,

Wood,

Stevenson

et al. 2023

Journal of the National Comprehensive Cancer Network

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Mesothelioma is a rare cancer originating in mesothelial surfaces of the peritoneum, pleura, and other sites. These NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) focus on peritoneal mesothelioma (PeM). The NCCN Guidelines for PeM provide recommendations for workup, diagnosis, and treatment of primary as well as previously treated PeM. The diagnosis of PeM may be delayed because PeM mimics other diseases and conditions and because the disease is so rare. The pathology section was recently updated to include new information about markers used to identify mesothelioma, which is difficult to diagnose. The term “malignant” is no longer used to classify mesotheliomas, because all mesotheliomas are now defined as malignant.

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“…10 ). Psammomatous calcifications within nodules may be seen in up to 30% of cases [ 2 , 31 , 33 ]. Elevation of serum levels of CA-125 is also present in the majority of cases [ 2 , 31 ].…”

Section: Primary Tumors Of the Peritoneummentioning

confidence: 99%

Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation

Miguez González,

Calaf Forn,

Pelegrí Martínez

et al. 2023

Insights Imaging

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Peritoneal malignancies represent a diagnostic challenge for abdominal radiologists, oncologists, surgeons and pathologists in multidisciplinary teams, who must address their differential diagnosis, staging and treatment. In this article, we explain the pathophysiology of these processes and lay out the role of different imaging techniques in their evaluation. Then, we review the clinical and epidemiological aspects, the main radiological features and the therapeutic approaches for each primary and secondary peritoneal neoplasm, with surgical and pathological correlation. We further describe other rare peritoneal tumors of uncertain origin and a variety of entities that may mimic peritoneal malignancy. Finally, we summarize the key imaging findings of each peritoneal neoplasm to facilitate an accurate differential diagnosis that may impact patient management.Clinical relevance statementImaging plays an essential role in the evaluation of peritoneal malignancies, assessing their extension, detecting unfavorable sites of involvement and facilitating an accurate differential diagnosis, helping to choose the best therapeutic approach. Graphical abstract

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CT imaging review of uncommon peritoneal-based neoplasms: beyond carcinomatosis

Cited by 9 publications

References 30 publications

Enhanced computed tomography imaging features predict tumor grade in pseudomyxoma peritonei

Enhanced computed tomography imaging features predict tumor grade in pseudomyxoma peritonei

Mesothelioma: Peritoneal, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology

Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation

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