The management of pseudomyxoma peritonei

Mann, William J.; Wagner, John L.; Chumas, John; Chalas, Eva

doi:10.1002/1097-0142(19901001)66:7<1636::aid-cncr2820660731>3.0.co;2-n

Cited by 104 publications

(61 citation statements)

References 18 publications

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“…This complex disease is found in 0.02% of laparotomies, and its incidence is threefold higher in females than in males (2,3). Pseudomyxoma peritonei usually originates from a perforated low-grade appendiceal mucinous neoplasm or appendiceal adenocarcinoma that protrudes into the peritoneum, and the initial presentation of the disease often includes increased abdominal girth and/or appendicitis-like symptoms (4).…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Treatment Decreases Microbial Burden Associated with Pseudomyxoma Peritonei and Affects β-Catenin Distribution

Semino–Mora

Testerman

Liu

et al. 2013

Clinical Cancer Research

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Purpose: Pseudomyxoma peritonei is an understudied cancer in which an appendiceal neoplasm invades the peritoneum and forms tumor foci on abdominal organs. Previous studies have shown that bacteria reside within pseudomyxoma peritonei tumors and mucin. Thus, we sought to analyze the effect of antibiotics on bacterial density and b-catenin expression within pseudomyxoma peritonei samples.Experimental Design: The study included 48 patients: 19 with disseminated peritoneal adenomucinosis (DPAM) and 29 with peritoneal mucinous carcinomatosis (PMCA). Fourteen patients were given antibiotics (30 mg lansoprazole, 1 g amoxicillin, and 500 mg clarithromycin) twice a day for 14 days. One week after completion of therapy, surgery was conducted and specimens were harvested for pathology, bacterial culture, ISH, and immunohistochemistry.Results: ISH showed the presence of bacteria in 83% of the patient samples, with a higher Helicobacter pylori density observed in PMCA versus DPAM. PMCA patients treated with antibiotics had a significantly lower bacterial density and decreased b-catenin levels in the cytoplasm, the cell nuclei, and mucin-associated cells. Although not significant, similar trends were observed in DPAM patients. Cell membrane b-catenin was significantly increased in both DPAM and PMCA patients receiving antibiotics.Conclusions: Bacteria play an important role in pseudomyxoma peritonei. Antibiotic treatment improved the histopathology of tissue, particularly in PMCA patients. In PMCA, antibiotics decreased bacterial density and were associated with a significant b-catenin decrease in the cytoplasm, cell nuclei, and mucin along with a small membrane increase. These results suggest that antibiotics offer potential protection against cell detachment, cellular invasion, and metastasis.

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Section: Introductionmentioning

confidence: 99%

Antibiotic Treatment Decreases Microbial Burden Associated with Pseudomyxoma Peritonei and Affects β-Catenin Distribution

Semino–Mora

Testerman

Liu

et al. 2013

Clinical Cancer Research

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“…The incidence of pseudomyxoma peritonei was estimated to be 2 in 10,000 laparotomies, with a female to male ratio of 3 to 1. 4,5 The mean age at occurrence is usually around 50 years. 6 The origin of these lesions in males in most cases is a mucinous tumor of the gastrointestinal tract, particularly the appendix; however, in females, the origin in particular cases is still controversial, being either the appendix or the ovary, especially when an ovarian mucinous tumor and appendiceal mucinous tumor co-exist.…”

Section: Discussionmentioning

confidence: 92%

Extraperitoneal Presentation of Pseudomyxoma Peritonei as a Scrotal Mass: Case Report and Review of the Literature

Al‐Bozom

2000

Ann Saudi Med

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IA Al-Bozom, Extraperitoneal Presentation of Pseudomyxoma Peritonei as a Scrotal Mass: Case Report and Review of the Literature. 2000; 20(3-4): [297][298][299] Pseudomyxoma is a poorly understood condition which results from implantation of malignant tumors or irritation from ruptured benign cysts.1 Pseudomyxoma peritonei is a form of regional spread of gastrointestinal, gynecological and other malignancies of mucinous nature.2 It is characterized by the accumulation of abundant mucinous material within the peritoneal cavity. The case presented here is unique in that extraperitoneal presentations of pseudomyxoma peritonei are exceedingly rare, and presentation with scrotal mass is even rarer. To the best of my knowledge, there is only one case in the English literature with similar scrotal mass presentation, and 10 other cases with other types of extraperitoneal presentations. Literature review of extraperitoneal presentation of pseudomyxoma peritonei is also discussed. Case ReportA 75-year-old male patient presented to King Khalid University Hospital with nine months' history of left testicular and groin swellings. The patient had a history of right inguinal hernia repair 24 years prior to the recent presentation. Initial examination revealed a normal testis with paratesticular swelling that measured 4.5 cm in diameter, and extended to the spermatic cord, where there was another smaller swelling at the level of the left groin. The swellings were firm, non-tender, irreducible and without cough impulse. Ultrasonography demonstrated the presence of hypoechoic nodules in relation to the epididymis, which focally had a beaded appearance, particularly at the spermatic cord level. There was no focal lesion seen in the testis. His initial workup showed microcytic hypochromic anemia (HB=6.3, MCV=59.7, MCH=17.5, MCHC=29.2), with mild thrombocytosis and ESR value of 66. Total serum iron level was 9 (normal value, 14-32 mmol/L), and TIBC (total iron-binding capacity) value was 40 (normal value, 40-70 mmol/L). The initial clinical impression was tuberculosis of the spermatic cord and testicular adnexa. Surgery was performed after limited anesthesia (spinal anesthesia) due to the poor general condition of the patient. The findings were of inguinal hernia sac communicating with the peritoneal cavity which drained yellowish fluid from the scrotum. Further dissection showed multiple yellow-gelatinous nodules along the spermatic cord and on the outer surface of the testis. Left orchiectomy and repair of the hernia were done.After the histopathology results, a thorough examination of the patient revealed multiple ill-defined paraumbilical swellings that were soft in consistency. Ultrasonography of the abdomen revealed multiple echogenic masses in the peritoneal cavity and multiple echogenic lesions in the liver. Barium enema, and upper and lower gastrointestinal endoscopies were unremarkable. Laparoscopy was performed under spinal anesthesia, and a large appendiceal mass with yellow surface and gelatinous consistency was seen. In...

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“…It often recurs after treatment and uncontrolled PMP can eventually cause death by dysfunctional abdominal viscera caused by compression with mucinous ascites. It is a rare condition that occurs in women, with an estimated incidence of 2 per 10,000 laparotomies (Mann et al 1990) or 1-2 per million inhabitants per year (Smeenk et al 2008). PMP is now considered to be of appendiceal origin (Ronnet et al 2004).…”

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confidence: 99%

Identifying Prognostic Factors in Japanese Women with Pseudomyxoma Peritonei: A Retrospective Clinico-Pathological Study of the Tohoku Gynecologic Cancer Unit

Kojimahara

Nakahara

Shoji

et al. 2011

Tohoku J. Exp. Med.

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Pseudomyxoma peritonei (PMP) is a rare condition of mucinous ascites associated mainly with mucinous tumors of appendix or ovary. PMP often recurs after treatment and may eventually cause death by abdominal visceral dysfunction via compression with mucinous ascites. Although radical peritonectomy and hyperthermic intra-peritoneal chemotherapy are becoming popular globally, the optimal treatment of PMP has not been established in Japan. We conducted a retrospective multicenter study to clarify the optimal treatment and the prognostic factors of PMP. A total of 23 patients with PMP were analyzed in the Tohoku Gynecologic Cancer Unit (TGCU). Clinical and follow-up data were retrieved and a central pathology review was performed. The median follow-up period was 46 months. Eleven patients underwent complete resection. There were 7 deaths out of 13 recurrences/progressions in this period. All the recurrence/ progression was confined to the abdomen. Unexpectedly, neither radical peritonectomy nor hyperthermic intra-peritoneal chemotherapy had been performed, indicating that both radical peritonectomy and hyperthermic intra-peritoneal chemotherapy are not yet popular in Japan. The medians of overall survival and disease-free period were 166 months and 30 months, respectively. Univariate and multivariate analyses revealed that the only prognostic factor was macroscopic residual tumor (P = 0.022). Although chemotherapy was not a prognostic factor (P = 0.16), those who received intra-peritoneal chemotherapy tended to have a better prognosis than those who received systemic or no chemotherapy (P = 0.064). In conclusion, the macroscopic residual tumor is an important prognostic factor in Japanese patients with PMP.

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The management of pseudomyxoma peritonei

Cited by 104 publications

References 18 publications

Antibiotic Treatment Decreases Microbial Burden Associated with Pseudomyxoma Peritonei and Affects β-Catenin Distribution

Antibiotic Treatment Decreases Microbial Burden Associated with Pseudomyxoma Peritonei and Affects β-Catenin Distribution

Extraperitoneal Presentation of Pseudomyxoma Peritonei as a Scrotal Mass: Case Report and Review of the Literature

Identifying Prognostic Factors in Japanese Women with Pseudomyxoma Peritonei: A Retrospective Clinico-Pathological Study of the Tohoku Gynecologic Cancer Unit

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