Peritoneal implants from ovarian tumors: CT findings.

Abstract

Metastatic peritoneal implants were assessed preoperatively with computed tomography (CT) in 38 patients with ovarian tumors. In the 106 biopsy specimens of gross peritoneal implants and the 118 random biopsy specimens obtained from these patients, metastatic deposits were detected in 27 of 38 (71%) patients and in 104 biopsy sites. CT depicted metastatic lesions in 17 of 27 (63%) patients and in 63 of 104 (61%) biopsy sites. The three sites most commonly involved were the right subphrenic region, the greater omentum, and the pouch of Douglas. The usefulness of CT in detecting lesions depended mainly on the location of the implant and the presence of adjacent ascites, rather than on lesion size.

Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer

“…The most common sites of abdominal deposits in our series were the right subdiaphragmatic space (18 patients), greater omentum (20 patients) and the pouch of Douglas (18 patients), as seen on CT. In a study of 38 patients, Buy et al [16] also reported these three sites as the most common locations for peritoneal deposits.…”

“…Although the detection of peritoneal implants will not change the therapeutic approach, CT is useful in the preoperative diagnosis of peritoneal carcinomatosis and for the detection of lesions not seen during surgery. Buy et al [16] observed a high specificity and PPV of CT for the diagnosis of peritoneal metastases.…”

MR imaging of peritoneal disease: comparison of contrast-enhanced fast multiplanar spoiled gradient-recalled and spin-echo imaging.

“…However, the MR findings of benign and malignant forms of peritoneal disease clearly overlap. In addition, many patients with peritoneal tumor had a range of peritoneal thickening at different anatomic sites, varying from slightly thickened (3)(4)(5) mm) to very thick (>1 cm) (Fig. 2).…”

Preferential Attachment of Peritoneal Tumor Metastases to Omental Immune Aggregates and Possible Role of a Unique Vascular Microenvironment in Metastatic Survival and Growth

“…[1][2][3] For these intra-abdominal tumors, direct intraperitoneal seeding is a common avenue of metastatic dissemination, although lymphatic and hematogenous spread can also occur. This direct seeding can arise when tumor cells are dislodged from the primary neoplasm, either naturally or during the process of surgical tumor resection, and the natural flow of peritoneal fluid then transports these malignant cells throughout the abdomen.…”