The many faces of pseudomyxoma peritonei: a radiological review based on 30 cases

Abstract

Objective: To determine the most common imaging features of pseudomyxoma peritonei (PMP), as well as the histologic subtypes of the primary tumors. Materials and Methods: We reviewed 30 cases of women with pathologically confirmed PMP. Only computed tomography scans were available. All cases were retrospectively studied by four radiologists, working independently. We identified the most common imaging findings, the predominant primary site of the disease, and the growth pattern. The most common sites of recurrence were also analyzed. Results: The most common computed tomography finding was peritoneal/omental nodules (including “omental caking”), followed by visceral scalloping and non-mucinous ascites. The most common site of the primary tumor was the appendix (in 63.3%), followed by the ovaries (in 16.6%), and 16.6% of the tumors were of undetermined origin. There was one case of synchronous appendiceal and ovarian tumors. Low-grade mucinous neoplasm was the most common histologic subtype, accounting for 84.2% of the appendiceal tumors and 40% of the ovarian tumors. Conclusion: Although PMP is a relatively rare entity, radiologists must be aware of its possible imaging findings, common locations, and possible patterns of recurrence. The origin of the primary tumor should also be investigated. Future studies are needed in order to determine which preoperative imaging findings predict surgical outcomes and to characterize the main findings of radiological recurrence.

Pseudomyxoma peritonei of appendiceal origin mimicking ovarian cancer – a case report with literature review

“…A computed tomography scan can also show low-attenuation lesions or loculated ascites scattered throughout the peritoneal cavity and individual peritoneal or omental nodules (omental cake in advance disease). Often it is hard to detect the primary tumor in a CT scan [17]. Moreover, many authors have reported appendiceal tumors and PMP, which mimic ovarian masses, and the patient underwent surgery with this diagnosis, as in our case [18][19][20].…”

“…Imaging modalities, mainly ultrasound and CT, may establish the diagnosis [2,5,11,17]. A specific sonography marker is the so-called "onion skin sign" and its "dumbbell structure" [18].…”

Ultrasound for Preoperatively Predicting Pathology Grade, Complete Cytoreduction Possibility, and Survival Outcomes of Pseudomyxoma Peritonei

“…The secretory function of the columnar cells was severely damaged, which led to a decrease in mucus secretion ( 2 , 6 , 18 ). Moreover, the concentrated tumor mass resulted in liver scalloping and omental cake ( 19 , 20 ). The current study results also demonstrated that the presence of omental cake predicted a higher pathological grade.…”

Comprehensive Understanding and Evolutional Therapeutic Schemes for Pseudomyxoma Peritonei

“… 33 It indicates that these gelatinous ascites and tumor cells follow the abdominal fluid circulation through lymphoid aggregates. 34 Mucus-secreting cells migrate with peritoneal fluid and keep in dynamic circulation because of the influence of body position, intraperitoneal pressure, and physical peritoneal fluid circulation. 35 Cells merely implant on tissues of relative standstill.…”