| Diagnosis and Treatment Modalities in Pseudomyxoma Peritonei. |
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Lee, Yeong Jin , Kim, Hee Cheol , Lee, Dong Hee , Yu, Chang Sik , Kim, Jin Cheon |
1Colorectal Clinic, Asan Medical Center, Korea. hckim@www.amc.seoul.kr
2Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea. |
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| Abstract |
Pseudomyxoma peritonei is an unusual condition in which gelatinous fluid collection is associated with mucinous implants on the peritoneal surfaces and omentum.
PURPOSE
The aim of this study was to evaluate the clinical characteristics of pseudomyxoma peritonei and elucidate the optimal treatment modality.
METHODS
Nine patients (male: female=2: 7) who had been operated on due to pseudomyxoma peritonei were analyzed retrospectively, in terms of clinical characteristics.
RESULTS
The common symptoms and signs were abdominal pain, mass and distension. Elevated serum carcinoembryonic antigen (CEA) level was found in six cases. CT and ultrasonography were most valid diagnostic tools for pseudomyxoma peritonei.
Six cases underwent debulking operation as initial treatment and two of them underwent intraoperative chemotherapy with 5-fluorouracil and other three cases did open biopsy. The origin of the primary tumor were appendix in three cases, ovary and appendix in three cases, ovary and colon in one case, ovary in one case, while the tumor origin could not be identified in one case. The three cases with cystadenoma remain free of disease after debulking operation. 2-Year survival rate of nine cases was 75%.
CONCLUSIONS
This study suggested that (1) the preoperative diagnosis could be made with careful physical examination in conjunction with sonography or computerized tomography; (2) the prognosis may be better in patient with benign origin and aggressive surgical management; (3) serum CEA level may be valuable for detection of this disease. |
| Key Words:
Pseudomyxoma peritonei; CEA; Computerized tomography |
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