Primary papillary serous carcinoma of the peritoneum diagnosed by video-assisted thoracoscopic surgery: Report of a case

Abstract

A 53-year-old woman who had end-stage renal disease and hypertension presented with back pain. Chest radiographs and chest computed tomography (CT) showed right pleural effusion with bilateral pleural masses. The patient underwent video-assisted thoracoscopic surgery (VATS) for a biopsy of the right pleural mass and for an evaluation of pleural effusion. A frozen section specimen suggested a papillary adenocarcinoma, which was confirmed to be metastatic primary papillary serous carcinoma of the peritoneum by immunohistochemistry, an elevated serum cancer antigen (CA-125) level, and abdominal CT findings. We found that the patient had been unfortunately misdiagnosed to have advanced colon cancer 11 years previously and thus had undergone a right hemicolectomy which was followed by six cycles of 5-fluorouracil chemotherapy. Despite this, she survived more than 10 years and was later correctly diagnosed by VATS of the pleural lesions and based on a review of the previous pathology. The patient was transferred to an oncologist to receive the proper chemotherapy with paclitaxel and carboplatin.

In pursuit of the primary

“…To the best of our knowledge, there have been only four other case reports in the English-language literature documenting EOPPC presenting with a pleural effusion [14][15][16][17]. Two of these reported patients who presented with dyspnoea secondary to massive pleural effusions in the absence of ascites or with minimal ascites, which is unusual.…”

Primary Peritoneal Serous Carcinoma Detected by Abnormal Cervical Smear: a Case Report

“…An asymptomatic, abdominal skin lesion that led to the diagnosis of PPSC was described by Cowan et al in 1995. 3 Another patient was diagnosed as having PPSC by a video-assisted thoracoscopic surgery due to bilateral pleural masses 4 , while three cases of PPSC [5][6][7] and one of serous peritoneal psammocarcinoma 8 were diagnosed by abnormal cytology ( Table 1). We report the fourth case of PPSC detected by abnormal cervical cytology, which is the first one with an absence of ovarian and tubal tissue at the time of the diagnosis.…”

Tumors, Tumor-Like Lesions, and Metaplastic Lesions of the Peritoneum

“…Similar to papillary serous ovarian carcinoma, rising longitudinal levels of CA125 may be significant in the detection of PPSCP (Skates et al 2003). PPSCP may extend beyond the abdominal cavity and involve the pleural surface (Suh et al 2008). The carcinoma can metastasize to locoregional lymph nodes and remote organs, including the bronchopulmonary tract (Nakao et al 2009) and the brain (Sakakibara et al 2011).…”