Synchronous mucinous tumors of the ovary and the appendix associated with pseudomyxoma peritonei: CT findings

Abstract

Radiologists should be familiar with the clinical occurrence of synchronous mucinous tumors of the ovary and the appendix associated with PMP and with the typical CT findings of the latter two entities. Alternatively, when the imaging findings suggest ovarian cystic tumor with PMP, the radiologist should be alerted to the probability of a clinically unsuspected appendiceal mucocele and should search for it.

Recurrent Localized Pseudomyxoma Peritonei in the Female Pelvis

“…The causal link between ovarian and appendiceal tumors is not clear as to whether these tumors have independent origins or not. It is believed that unilateral mucinous tumors originate from the ovary and that bilateral ovarian mucinous tumors are secondary [1,11,17]. Ronnett et al [11] argued that ovarian mucinous tumors with PMP mainly reflect secondary involvement.…”

“…In some cases, synchronous mucinous tumors of the ovary and the appendix may occur and occult primary appendiceal tumors may be revealed by postoperative histopathologic examination [17]. When mucinous fluid-like materials localize in the female pelvic cavity with ovarian involvement, this may mimic ovarian carcinomatous peritonitis and may be treated as a gynecologic disease [2].…”

Mucocele of the Vermiform Appendix with Sonographic Appearance of an Adnexal Mass

“…In women, mucocele of the appendix can be sometimes misdiagnosed as a mass of the right adnexum, because of its clinical and ultrasonographic presentation [1,2] . Diagnosis can become even more complex due to the occurrence of synchronous mucinous tumors of the appendix and the ovary [11] , due to presentation during pregnancy [12] , and due to increased levels of serum tumor markers [2] . In a previously reported case, mucinous cystadenoma of the appendix presented mimicking ovarian cancer with increased levels of serum carcinoembryonic antigen (CEA) [2] .…”

“…In the present case, the mucocele appeared on ultrasound as a cystic mass, with thick walls and a sonolucent area behind it, and it was surrounded by a small amount of free fl uid. Although the appendiceal origin of the pelvic mass was evident during the operation, a total abdominal hysterectomy and bilateral salpingoophorectomy was performed for staging purposes; radical operation allowed histological exclusion of primary or concurrent [11] ovarian and/or endometrial adenocarcinoma. Moreover, the patient opted preoperatively for a radical operation, given the possibility of malignancy.…”

Milzmetastasen bei Pseudomyxoma peritonei

“…Innerhalb der Tumormassen lassen sich Kalzifikationen nachweisen [3,4]. In Abbildung 2 ist das histologische Bild des in der vorliegenden Kasuistik beschriebenen Patienten mit Pseudomyxoma peritonei dargestellt.…”