CT appearance of primary papillary serous carcinoma of the peritoneum.

Abstract

P rimary papillary serous carci noma of the peritoneum is a rare primary tumor of the peritoneum that is found predominantly in elderly, post menopausal women [1 ]. The incidence of primary papillary serous carcinoma of the peritoneum has been estimated to be be tween 6.5% and 7.5% of all casesof initially clinically suspected ovarian epithelial carci noma or papillary serouscarcinoma when re assessed in retrospective series [2].Primary papillary serous carcinoma of the peritoneum shares many identical features with its ovarian analogue, serous ovarian papillary carcinoma, and two theories have been proposed to explain their similarities. The first suggests that primary papillary se rous carcinoma of the peritoneum arises from malignant degeneration of nests of ovarian tis sue remnants that are left within the peri toneum during the process of embryonic gonadal migration [3]. The second theory sug gests that the similarities of the two entities are based on the common origin of ovarian epithelium and pentoneum from mesoderm that has mGllerian potential [4]. Histologi cally, primary papillary serous carcinoma of the peritoneum and serous ovarian papillary carcinomaareindistinguishable, althoughpri mary papillary serous carcinoma of the peritoneum characteristically involves the ovaries only superficially or may totally lack an ovarian component [5].To our knowledge, the radiologic features of primary papillary serous carcinoma of the peritoneum have not been reported. The aim of this study was to describe the CT features of pathologically proven primary papillary serous carcinoma of the peritoneum in seven patients. Materials and Methods PatientsSeven patients with pathologically proven pri mary papillary serous carcinoma of the perito neum who had undergone abdominal and pelvic CT formedthestudypopulation. All patientswere women who were 40â€"77 years old (mean age, 59 years old). Six (86%) of the seven patients were postmenopausal. The presenting complaints were nonspecific and included abdominal pain (n = 5), anorexia (n = 3), and bloating (n = 2). Four pa tients had a combination of symptoms. Two pa tients had peritoneal masses detected unexpectedly while undergoing elective surgery (hysterectomy; opencholecystectomy). Thesetwo patientssubse quently underwent CT. In a third patient who was beingevaluated for abdominal pain,CT revealed a large peritoneal mass that abutted the transverse Received January15,1998; acceptedafterrevision March16,1998. CONCLUSION. The presenceof peritonealmasses, extensiveomentalcalcification,and the absence of an ovarian mass on CTâ€"particularly in postmenopausal womenâ€"is highly suggestive of primary papillary serous carcinoma of the peritoneum and should alert the radi ologist to the possibility of this diagnosis. Downloaded from www.ajronline.org by 54.245.55.244 on 05/11/18 from IP address 54.245.55.244.

Primary peritoneal carcinoma: experience with cytoreductive surgery and combination chemotherapy

“…However, the etiology, pathogenesis, cell of origin, and clinical characteristics of PPC remain obscure. Differential diagnosis may include adenocarcinoma of unknown primary tissue, malignant mesothelioma, and peritoneal adenocarcinoma, as well as metastatic breast, gastrointestinal, and ovarian malignancies (20) .…”

Dropped gallstones mimicking peritoneal metastasis: A case report

“…Malignant multiple CPNPs are Mainly due to calcified nodules of carcinomatosis [5] . The presence of multiple calcified peritoneal nodules, especially if associated with extensive omental calcification, suggests the diagnosis of ovarian papillary serous carcinoma in cases of ovarian mass and of primary papillary serous carcinoma in the absence of ovarian mass, particularly in postmenopausal women [14] .…”

A diagnostic dilemma following risk-reducing surgery for BRCA1 mutation – a case report of primary papillary serous carcinoma presenting as sigmoid cancer

“…Diagnosing PSCP can be particularly challenging as most peritoneal carcinomas present late and are difficult to detect both clinically and radiologically. There are certain CT features which are specific to peritoneal disease, but these are subtle and may only help in differentiating from other similar lesions such as mesothelioma and metastatic disease [ 14 ]. There is some role for serial tumour marker measurements (CA-125) but this may be misleading.…”