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Veron Sanchez A, Bennouna I, Coquelet N, Cabo Bolado J, Pinilla Fernandez I, Mullor Delgado LA, Pezzullo M, Liberale G, Gomez Galdon M, Bali MA. Unravelling Peritoneal Carcinomatosis Using Cross-Sectional Imaging Modalities. Diagnostics (Basel) 2023; 13:2253. [PMID: 37443647 DOI: 10.3390/diagnostics13132253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Peritoneal carcinomatosis (PC) refers to malignant epithelial cells that spread to the peritoneum, principally from abdominal malignancies. Until recently, PC prognosis has been considered ill-fated, with palliative therapies serving as the only treatment option. New locoregional treatments are changing the outcome of PC, and imaging modalities have a critical role in early diagnosis and disease staging, determining treatment decision making strategies. The aim of this review is to provide a practical approach for detecting and characterizing peritoneal deposits in cross-sectional imaging modalities, taking into account their appearances, including the secondary complications, the anatomical characteristics of the peritoneal cavity, together with the differential diagnosis with other benign and malignant peritoneal conditions. Among the cross-sectional imaging modalities, computed tomography (CT) is widely available and fast; however, magnetic resonance (MR) performs better in terms of sensitivity (92% vs. 68%), due to its higher contrast resolution. The appearance of peritoneal deposits on CT and MR mainly depends on the primary tumour histology; in case of unknown primary tumour (3-5% of cases), their behaviour at imaging may provide insights into the tumour origin. The timepoint of tumour evolution, previous or ongoing treatments, and the peritoneal spaces in which they occur also play an important role in determining the appearance of peritoneal deposits. Thus, knowledge of peritoneal anatomy and fluid circulation is essential in the detection and characterisation of peritoneal deposits. Several benign and malignant conditions show similar imaging features that overlap those of PC, making differential diagnosis challenging. Knowledge of peritoneal anatomy and primary tumour histology is crucial, but one must also consider clinical history, laboratory findings, and previous imaging examinations to achieve a correct diagnosis. In conclusion, to correctly diagnose PC in cross-sectional imaging modalities, knowledge of peritoneal anatomy and peritoneal fluid flow characteristics are mandatory. Peritoneal deposit features reflect the primary tumour characteristics, and this specificity may be helpful in its identification when it is unknown. Moreover, several benign and malignant peritoneal conditions may mimic PC, which need to be considered even in oncologic patients.
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Affiliation(s)
- Ana Veron Sanchez
- Hospital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium
| | - Ilias Bennouna
- Hospital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium
| | - Nicolas Coquelet
- Hospital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium
| | | | | | | | - Martina Pezzullo
- Hôpital Universitaire de Bruxelles, Hôpital Erasme, 1070 Brussels, Belgium
| | - Gabriel Liberale
- Hospital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium
| | - Maria Gomez Galdon
- Hospital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium
| | - Maria A Bali
- Hospital Universitaire de Bruxelles, Institut Jules Bordet, 1070 Brussels, Belgium
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Yuan J, He L, Han B, Li Y. Long-term survival of high-grade primary peritoneal papillary serous adenocarcinoma: a case report and literature review. World J Surg Oncol 2017; 15:76. [PMID: 28399919 PMCID: PMC5387239 DOI: 10.1186/s12957-017-1134-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/22/2017] [Indexed: 01/05/2023] Open
Abstract
Background Primary peritoneal papillary serous carcinoma (PPPSC) is an uncommon disease which has a high malignancy and a poor prognosis. Case presentation We report here a long-term survival case of PPPSC with postoperative lung metastasis. A 62-year-old female patient with PPPSC was administered two cycles of neoadjuvant chemotherapy (NAC) followed by cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and six cycles of platinum-based (docetaxel + carboplatin) intraperitoneal chemotherapy postoperatively. The patient reached a complete remission at the completion of primary treatment. Malignant thoracic effusion and lung metastasis developed 5 months after the treatment. The patient underwent video-assisted thoracoscopic surgery plus hyperthermic intrapleural chemotherapy. Conclusions Up to present, the patient has been survived with tumor for over 86 months with a good performance status, with only encapsulated effusion found at the latest follow-up. As a relatively new regime, the application of CRS + HIPEC in our patient has been proved example for MPE management, although more large-scale studies are needed to substantiate its efficiency and safety.
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Affiliation(s)
- Jingping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China
| | - Liang He
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital Affiliated to the Capital Medical University, Beijing, 100038, People's Republic of China
| | - Bing Han
- Department of Pathology, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Yan Li
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital Affiliated to the Capital Medical University, Beijing, 100038, People's Republic of China.
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Cheng Z, Yang W, Guo J, Luo N, Chen L, Xie Y, Qu X, Hu L, Dai H, Zuo X. Genetic landscape of a case of extraovarian peritoneal serous papillary carcinoma. Oncol Lett 2016; 12:2395-2402. [PMID: 27698805 PMCID: PMC5038161 DOI: 10.3892/ol.2016.4933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/21/2016] [Indexed: 12/05/2022] Open
Abstract
The present report aimed to study genetic alterations underlying extraovarian peritoneal serous papillary carcinoma (EPSPC), which have not previously been systematically investigated. A case of EPSPC was identified, and its genetic alterations were assessed by combining comparative genomic hybridization and whole-exome sequencing technologies to investigate the genomic landscape, including copy number variations and mutations in EPSPC. It was found that a large number of germline mutations were present, which may have predisposed the patient to the occurrence of this disease. Copy number gains were found in a range of chromosomes, including 4q, 5q, 8q, 10q, 15q, 16p, 18q, 20p, 20q and Xq. Large-scale copy number loss occurred in chromosomes 2p, 13q, 16q, 17p and 17q. Through use of whole-exome sequencing, germline mutations were widely found that were associated with cancer development, including mutations in the BRCA1, DNA repair associated (BRCA1), BRCA2, tumor protein 53, erb-b2 receptor tyrosine kinase 2, matrix metalloproteinases and ADAM metallopeptidase domain-containing genes. In addition, 165 somatic mutations, including 52 missense mutations and 7 short insertions or deletions, were also identified. In summary, the EPSPC was undergoing profound genomic rearrangement and somatic mutation, which may have led to its initiation and development, and the present study discussed the genetic basis of this highly malignant cancer.
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Affiliation(s)
- Zhongping Cheng
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Weihong Yang
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Jing Guo
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Ning Luo
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Li Chen
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Yan Xie
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Xiaoyan Qu
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Liping Hu
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Hong Dai
- Department of Gynecology and Obstetrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China; Gynecology Minimally Invasive Medical Institute, School of Medicine, Tongji University, Shanghai 200090, P.R. China
| | - Xiaoming Zuo
- Department of Pathology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, P.R. China
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Kim YM, Lee YM, Lee SH, Lee DW, Kim KH. Primary Peritoneal Carcinoma Initially Presenting as Atypical Cervical Lymphadenopathy. Case Rep Oncol 2015; 8:246-50. [PMID: 26120309 PMCID: PMC4478334 DOI: 10.1159/000431253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Primary peritoneal carcinoma (PPC) is a rare cancer arising from the extraovarian peritoneum and is of müllerian origin. PPC and epithelial ovarian carcinoma share similar clinical, histopathological, and immunohistochemical features. Clinical symptoms and findings include abdominal distension and ascites. We experienced 2 cases of PPC which initially presented with cervical lymphadenopathy. Here, we report the 2 cases and review the literature.
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Affiliation(s)
- Yun Mi Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Yeong Min Lee
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Si Hyeing Lee
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Dong Woo Lee
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ki Hyang Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
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McDuff SGR, Yashar CM. Radiation Therapy in Gynecologic Cancer. Gynecol Oncol 2015. [DOI: 10.1007/978-1-4939-1976-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rakheja R, Makis W, Hickeson M. Extraovarian primary peritoneal carcinoma: staging with 18F-FDG PET/CT. ACTA ACUST UNITED AC 2012; 37:304-8. [PMID: 21394599 DOI: 10.1007/s00261-011-9722-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A 69-year-old woman who presented with left lower quadrant abdominal pain and elevated serum cancer antigen 125 (CA-125) levels was referred for an MRI and an (18)F-FDG PET/CT to evaluate a suspicious abdominal mass seen on ultrasound. PET/CT showed extensive, intensely FDG-avid, omental and pelvic peritoneal thickening with no suspicious ovarian or colon masses. Based on the PET/CT results, the patient had extensive debulking surgery and histopathological evaluation revealed an extraovarian primary peritoneal carcinoma (EOPPC). (18)F-FDG PET/CT may be useful in differentiating EOPPC from other types of peritoneal carcinomatosis, and in determining the extent of the disease to better guide surgical management and improve long term outcomes.
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Affiliation(s)
- Rajan Rakheja
- Department of Nuclear Medicine, McGill University Health Centre, Montreal, QC, Canada
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Li J, Fadare O, Xiang L, Kong B, Zheng W. Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis. J Hematol Oncol 2012; 5:8. [PMID: 22405464 PMCID: PMC3328281 DOI: 10.1186/1756-8722-5-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 03/09/2012] [Indexed: 12/30/2022] Open
Abstract
Recent morphologic and molecular genetic studies have led to a paradigm shift in our conceptualization of the carcinogenesis and histogenesis of pelvic (non-uterine) serous carcinomas. It appears that both low-grade and high-grade pelvic serous carcinomas that have traditionally been classified as ovarian in origin, actually originate, at least in a significant subset, from the distal fallopian tube. Clonal expansions of the tubal secretory cell probably give rise to serous carcinomas, and the degree of ciliated conversion is a function of the degree to which the genetic hits deregulate normal differentiation. In this article, the authors review the evidentiary basis for aforementioned paradigm shift, as well as its potential clinical implications.
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Affiliation(s)
- Jie Li
- Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, Shandong, China 250012
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Shim HJ. Tertiary syphilis mimicking hepatic metastases of underlying primary peritoneal serous carcinoma. World J Hepatol 2010; 2:362-6. [PMID: 21161022 PMCID: PMC2999301 DOI: 10.4254/wjh.v2.i9.362] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 09/05/2010] [Accepted: 09/12/2010] [Indexed: 02/06/2023] Open
Abstract
Tertiary syphilis, especially in cases involving visceral gummatous disease, can be confused with cancer of the solid organs. We report a case of tertiary hepatic syphilis that manifested with intrahepatic masses in a patient who had an underlying primary peritoneal serous carcinoma (PPSC). The patient was diagnosed with PPSC and achieved a complete remission of PPSC following six cycles of platinum-based chemotherapy. Two hepatic nodules developed during the follow-up period and were initially labeled as hepatic metastases from the underlying PPSC, based on radiological findings. A resection of hepatic nodules was performed for therapeutic and diagnostic purposes, because there were no other metastatic foci except in the liver. Unexpectedly, serology and histology confirmed tertiary syphilis. This rare case emphasizes the importance of including tertiary syphilis in the differential diagnosis of a space-occupying lesion, even with an existing diagnosis of underlying cancer.
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Affiliation(s)
- Hyun Jeong Shim
- Hyun Jeong Shim, Chonnam National University Hwasun Hospital 160, Ilsimri, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-809, South Korea
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Localized intrapancreatic malignant mesothelioma: a rare entity that may be confused with other pancreatic neoplasms. Virchows Arch 2010; 456:455-61. [PMID: 20148337 DOI: 10.1007/s00428-010-0885-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 12/22/2009] [Accepted: 01/11/2010] [Indexed: 12/19/2022]
Abstract
Malignant mesothelioma usually presents with diffuse involvement of the pleura or peritoneum. Circumscribed or localized malignant mesothelioma has been described in these locations, as well as the viscera, in which case it may cause diagnostic confusion with other, more common entities. Herein, we describe the first well-documented case of primary intrapancreatic malignant mesothelioma in the English literature. The patient was an otherwise healthy 39-year-old woman who presented with a symptomatic mass in the head of the pancreas that was completely resected via pancreaticoduodenectomy. The tumor was composed of cysts, papillae, and tubules lined by cells with abundant eosinophilic cytoplasm and immunohistochemically expressed CA-125, calretinin, and D2-40. Follow-up revealed no evidence of residual or recurrent disease 32 months after surgery. This report also describes the clinical and pathologic characteristics of an intrapancreatic mesothelioma and provides a review of the literature regarding entities that may be considered in the differential diagnosis of this tumor.
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Agarwal R, Sharma S, Guleria K, Radhakrishnan G, Radhika AG. Primary peritoneal carcinoma: a diagnostic dilemma. Arch Gynecol Obstet 2010; 282:115-6. [PMID: 20043172 DOI: 10.1007/s00404-009-1343-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 12/15/2009] [Indexed: 11/27/2022]
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