Peritoneal carcinomatosis

Case contributed by Dr Heba Mohamed

Presentation

A known case of cancer of the stomach.

Patient Data

Age: 46 years
Gender: Male
CT

Abnormal low attenuation loculated fluid throughout the peritoneal cavity associated with scalloping of the liver and splenic surfaces as well as the lesser curve of the stomach. Abnormal soft tissue mass is seen studded over the omentum measures 78x187 mm.

An arc-like calcification is seen in the right lumbar region.

Minimal left side pleural effusion is demonstrated within the chest.

Case Discussion

Despite the overlapping criteria of both Pseudomyxoma peritonei and Peritoneal carcinomatosis the following may be helpful in the differentiation process:

1. Pseudomyxoma peritonei typically occurs with a low-grade mucinous neoplasm (appendicular mucocele and some time ovarian neoplasm, non-mobile on ultrasonography and scallops the visceral surface on CT. No associated with direct organ invasion, distant or lymphatic spread.

2. Peritoneal carcinomatosis: occurs in high-grade mucinous neoplasm (gastrointestinal tract,
gallbladder, pancreas, ovary), freely mobile on ultrasonography and does not scallop the visceral surface on CT. Usually, involves the chest by metastasis or effusion, and associated with enlarged abdominal lymph nodes, omental cake, and direct organ invasion.

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Case information

rID: 54990
Case created: 12th Aug 2017
Last edited: 8th Nov 2017
Inclusion in quiz mode: Included

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