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Zhao XY, Li CQ, Zhang SY, Liu G. Case Report: An Unusual Case of Pulmonary Metastatic Adenocarcinoma From Low-Grade Appendiceal Mucinous Neoplasms. Front Oncol 2022; 12:906344. [PMID: 35912193 PMCID: PMC9327614 DOI: 10.3389/fonc.2022.906344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background Low-grade appendiceal mucinous neoplasms (LAMNs) are indolent tumors with low-grade cytology. Although peritoneal dissemination is common due to tumor rupture and mucinous deposits on the visceral peritoneal surface, distant involvement, such as lung, is rarely seen due to lack of invasiveness. Case Presentation A 70-year-old woman presented to the hospital due to continuously elevated carcinoembryonic antigen (CEA) levels for 10 months without any symptoms. PET/CT revealed two lesions located in the left lung and appendix. The postoperative pathology results revealed pulmonary mucinous adenocarcinoma and LAMN. Then we performed next-generation sequencing (NGS) to clarify the relationship between the two tumors. The sequencing result showed that both tumors harbored the common tumor mutations, KRAS (p.G12D), GNAS (p.R201H), and BRAF (p.R735Q), which indicated that the pulmonary tumor was a metastasis of LAMN. Conclusion This case is unusual in that the primary LAMN and the pulmonary metastasis are present at the time of diagnosis. This study reported the first pulmonary metastasis from LAMN verified by NGS.
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Patel BK, Singh AR, Umamahesweran S, Ashok Badhe B. Vermiform Appendix and the Potential for Missed Pathologies. Cureus 2022; 14:e25055. [PMID: 35719826 PMCID: PMC9199560 DOI: 10.7759/cureus.25055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The appendix is considered an appendage of little value and is often treated disdainfully, be it as part of evolutionary process, on a grossing table, under a microscope or while archiving specimens and slides. It is only recently, with data indicating its importance in gut immunity and as the origin of pseudomyxoma, that its space in a human body appears vindicated. Aim Our aim was to screen the histopathologic spectrum of appendix lesions observed in our hospital for rare, incidental or clinico-radiologically uncertain lesions that would help emphasize a necessary seriousness in its sampling. Method All appendectomy specimens over ten years were screened for diagnosis other than acute/chronic/resolving appendicitis and pseudomyxoma peritonei. Among the recorded rare diagnoses, one representative case each, based on interesting history or pathology, was selected for discussion. Observation Forty-three lesions were found to meet inclusion criteria comprising 12 varied etiologies. Among these, 25 had a normal-appearing appendix and 27 were not suspected on radiology or on clinical/surgical assessment. Histopathology comprised, among others, neoplastic entities such as (Diffuse large B-cell) lymphoma, metastasis, carcinoid as well as interesting non-neoplastic diagnoses such as pinworm infestation (in the elderly) and (post-menopausal) endometriosis. Conclusion Sampling and histopathologic assessment of the appendix should be compulsory, careful and representative. Each specimen must be treated as harboring a potential pathology, until microscopically proven otherwise because missed “rare” diagnoses could delay therapy or alter key management decisions as cancer staging.
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Milandt N, Birkelund T, Engholm M. Acute Chylopericardium With Tamponade and Cardiac Arrest With Pseudomyxoma Peritonei. Am J Cardiol 2021; 146:134-136. [PMID: 33548186 DOI: 10.1016/j.amjcard.2021.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022]
Abstract
A 51-year-old woman with pseudomyxoma peritonei developed cardiac arrest 5 days after surgery. Acute echocardiography demonstrated pericardial tamponade. Emergency pericardiocentesis evacuated milky fluid and circulation was re-established. Analysis of the pericardial fluid suggested chylopericardium. In conclusion, this case demonstrates that chylopericardium may be life-threatening and underlines the importance of acute echocardiography in critical management of patients with unexplained shock.
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Affiliation(s)
- Nikolaj Milandt
- Department of Intensive Care Medicine, Aarhus University Hospital, Denmark.
| | - Thomas Birkelund
- Department of Intensive Care Medicine, Aarhus University Hospital, Denmark
| | - Morten Engholm
- Department of Cardiology, Aarhus University Hospital, Denmark
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Clinicopathologic Features and Risk Factors for Recurrence of Mucinous Borderline Ovarian Tumors: A Retrospective Study With Follow-up of More Than 10 Years. Int J Gynecol Cancer 2019; 28:1643-1649. [PMID: 30365456 DOI: 10.1097/igc.0000000000001362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the clinicopathologic features of mucinous borderline ovarian tumors (MBOTs), with an emphasis on the risk factors for recurrence. METHODS Data of 76 patients with MBOT diagnosed and treated between 2000 and 2007 at a single institution were analyzed in this retrospective study. The clinicopathologic features of different tumor subgroups were analyzed, including pathology, surgical methodology, recurrence, and overall survival. RESULTS The median patient age was 40 years (13-85 years). Forty-six patients with gastrointestinal mucinous borderline tumors (intestinal MBOTs) (73.7%) and 20 patients with endocervical MBOT (26.3%) were identified. Forty radical surgeries and 26 conservative surgeries were performed. There were 74.6% patients (50/67) with stage I disease among the 67 patients who received comprehensive surgical staging.During a median follow-up time of 151 months, 9 recurrences were identified. Median duration from surgery to recurrence was 26.4 months (range, 13-50 months). There was no difference in recurrence rate between intestinal MBOT and endocervical MBOT (14.3% vs 5.0%; P > 0.05). The recurrence rate of stage III tumors was significantly higher than that of stage I (33.3% vs 8%; P < 0.05). The recurrence rate after conservative surgery was higher than that after radical procedures (21.4% vs 6.3%; P < 0.05). CONCLUSIONS The majority of patients with MBOT had a favorable prognosis. Patients with later-stage disease had a higher recurrence rate.
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6
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Delhorme JB, Severac F, Averous G, Glehen O, Passot G, Bakrin N, Marchal F, Pocard M, Lo Dico R, Eveno C, Carrere S, Sgarbura O, Quenet F, Ferron G, Goéré D, Brigand C. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei of appendicular and extra-appendicular origin. Br J Surg 2018; 105:668-676. [PMID: 29412465 DOI: 10.1002/bjs.10716] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/29/2017] [Accepted: 09/03/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The prognostic value of the primary neoplasm responsible for pseudomyxoma peritonei (PMP) remains poorly studied. The aim of this study was to determine the prognosis for patients with extra-appendicular PMP (EA-PMP) treated optimally with complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS All patients treated for PMP with CCRS and HIPEC between 1994 and 2016 were selected retrospectively from a French multicentre database. Patients with EA-PMP had pathologically confirmed non-neoplastic appendices and were matched in a 1 : 4 ratio with patients treated for appendicular PMP (A-PMP), based on a propensity score. RESULTS Some 726 patients were identified, of which 61 (EA-PMP group) were matched with 244 patients (A-PMP group). The origins of primary tumours in the EA-PMP group included the ovary (45 patients), colon (4), urachus (4), small bowel (1), pancreas (1) and unknown (6). The median peritoneal carcinomatosis index was comparable in EA-PMP and A-PMP groups (15·5 versus 18 respectively; P = 0·315). In-hospital mortality (3 versus 2·9 per cent; P = 1·000) and major morbidity 26 versus 25·0 per cent; P = 0·869) were also similar between the two groups. Median follow-up was 66·9 months. The 5-year overall survival rate was 87·8 (95 per cent c.i. 83·2 to 92·5) per cent in the A-PMP group and 87 (77 to 96) per cent in the EA-PMP group. The 5-year disease-free survival rate was 66·0 (58·7 to 73·4) per cent and 70 (53 to 83) per cent respectively. CONCLUSION Overall and disease-free survival following treatment with CCRS and HIPEC is similar in patients with pseudomyxoma peritonei of appendicular or extra-appendicular origin.
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Affiliation(s)
- J-B Delhorme
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - F Severac
- Department of Public Health, Strasbourg University Hospital, Strasbourg, France
| | - G Averous
- Department of Pathology, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - O Glehen
- Department of General and Oncological Surgery, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - G Passot
- Department of General and Oncological Surgery, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - N Bakrin
- Department of General and Oncological Surgery, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - F Marchal
- Department of Surgical Oncology, Alexis Vautrin Lorraine Institute of Oncology, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - M Pocard
- Surgical Oncology and Digestive Unit, Lariboisière University Hospital, Paris, France
| | - R Lo Dico
- Surgical Oncology and Digestive Unit, Lariboisière University Hospital, Paris, France
| | - C Eveno
- Surgical Oncology and Digestive Unit, Lariboisière University Hospital, Paris, France
| | - S Carrere
- Department of Surgical Oncology, Montpellier Cancer Centre, Montpellier, France
| | - O Sgarbura
- Department of Surgical Oncology, Montpellier Cancer Centre, Montpellier, France
| | - F Quenet
- Department of Surgical Oncology, Montpellier Cancer Centre, Montpellier, France
| | - G Ferron
- Department of Surgical Oncology, Claudius Regaud Institute, Toulouse, France
| | - D Goéré
- Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif Cedex, France
| | - C Brigand
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
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Stein EB, Wasnik AP, Sciallis AP, Kamaya A, Maturen KE. MR Imaging-Pathologic Correlation in Ovarian Cancer. Magn Reson Imaging Clin N Am 2017; 25:545-562. [PMID: 28668159 DOI: 10.1016/j.mric.2017.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There are many ovarian cancer subtypes, giving rise to a range of appearances at gross pathology and magnetic resonance (MR) imaging. Certain fundamental concepts at MR, arising from underlying tissue characteristics, can provide guidance to radiologists in suggesting a diagnosis. The ability of multiparametric MR to risk stratify ovarian masses can contribute substantially to clinical decision making and patient management.
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Affiliation(s)
- Erica B Stein
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
| | - Ashish P Wasnik
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Andrew P Sciallis
- Department of Pathology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Aya Kamaya
- Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Katherine E Maturen
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; Department of Obstetrics & Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Villeneuve L, Passot G, Glehen O, Isaac S, Bibeau F, Rousset P, Gilly FN. The RENAPE observational registry: rationale and framework of the rare peritoneal tumors French patient registry. Orphanet J Rare Dis 2017; 12:37. [PMID: 28212684 PMCID: PMC5316145 DOI: 10.1186/s13023-017-0571-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/13/2017] [Indexed: 01/23/2023] Open
Abstract
Background Rare peritoneal cancers represent complex clinical situations requiring a specific and multidisciplinary management. Because of their rarity, lack of awareness and knowledge often leads to diagnostic delays and misdiagnosis. And patients are not systematically referred to expert centers as they should be. Clinicians and researchers also face unique challenges with these rare cancers, because it is hard to conduct adequately powered, controlled trials in such small patient population. This is how an observational patient registry constitutes a key instrument for the development of epidemiological and clinical research in the field of these rare cancers. It is the appropriate tool to pool scarce data for epidemiological research and to assess the impact of diagnostic and therapeutic strategies. We aimed to provide the outlines and the framework of the RENAPE observational registry and share our experience in the establishment of a national patient registry. Results The RENAPE observational registry has been launched in 2010 thanks to institutional supports. It concerns only patients with a histological diagnosis confirming a peritoneal surface malignancy. A web secured clinical database has been implemented based on data management procedures according to the principles of international recommendations and regulatory statements. A virtual tumor bank is linked in order to the conduct translational studies. Specialized working groups have been established to continuously upgrade and evolve the common clinical and histological data elements following the last classifications and clinical practices. They contribute also to standardize clinical assessment and homogenize practices. Conclusions The RENAPE Registry may improve awareness and understanding of the rare peritoneal tumors into the incidence, prevalence, recurrence, survival and mortality rates, as well as treatment practices thereby enabling therapeutic intervention to be evaluated and ultimately optimized. Trial registration ClinicalTrials.gov Identifier: NCT02834169
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Affiliation(s)
- L Villeneuve
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France. .,EMR 3738, Lyon 1 University, Lyon, France. .,RENAPE, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France.
| | - G Passot
- EMR 3738, Lyon 1 University, Lyon, France.,Department of Digestive Surgery, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - O Glehen
- EMR 3738, Lyon 1 University, Lyon, France.,Department of Digestive Surgery, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - S Isaac
- EMR 3738, Lyon 1 University, Lyon, France.,Department of Pathology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - F Bibeau
- Department of Pathology, Centre Hospitalier Universitaire, Caen, France
| | - P Rousset
- EMR 3738, Lyon 1 University, Lyon, France.,Department of Radiology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - F N Gilly
- EMR 3738, Lyon 1 University, Lyon, France.,Department of Digestive Surgery, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
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Ghosh RK, Somasundaram M, Ravakhah K, Hassan C. Pseudomyxoma peritonei with intrathoracic extension: a rare disease with rarer presentation from low-grade mucinous adenocarcinoma of the appendix. BMJ Case Rep 2016; 2016:bcr-2015-211076. [PMID: 26729823 DOI: 10.1136/bcr-2015-211076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pseudomyxoma peritonei is an extremely rare disease, characterised by mucinous ascites and implants, diffusely involving the peritoneal surfaces. Recent pathological and genetic advances indicate that they mostly originate from an appendiceal adenoma or adenocarcinoma. The successful treatment of peritoneal carcinomatosis requires a comprehensive management plan including cytoreductive surgery, intraoperative intraperitoneal heated chemotherapy and postoperative systemic chemotherapy. It is extremely rare to have intrathoracic spread of the disease at initial presentation. Some of the possible hypotheses of neoplastic cells spreading into the pleural cavity include congenital or acquired pleura-peritoneal communications, invasion of lymphovascular space and, rarely, through direct invasion of the diaphragm.
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Affiliation(s)
- Raktim K Ghosh
- Department of Internal Medicine, St Vincent Charity Medical Center, An Affiliate of Case Western Reserve University, Cleveland, Ohio, USA
| | - Mey Somasundaram
- Department of Internal Medicine, St Vincent Charity Medical Center, An Affiliate of Case Western Reserve University, Cleveland, Ohio, USA
| | - Keyvan Ravakhah
- Department of Internal Medicine, St Vincent Charity Medical Center, An Affiliate of Case Western Reserve University, Cleveland, Ohio, USA
| | - Chandra Hassan
- Department of Bariatric Surgery, St Vincent Charity Medical Center, An Affiliate of Case Western Reserve University, Cleveland, Ohio, USA
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10
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Pocard M. [The peritoneum is a full specific organ, requiring specific pathological exams]. Ann Pathol 2015; 35:273-4. [PMID: 26256741 DOI: 10.1016/j.annpat.2015.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Marc Pocard
- Université Paris Diderot, Sorbonne Paris Cité, AP-HP, hôpital Lariboisière, chirurgie digestive et cancérologique, 2, rue Ambroise-Paré, 75475 Paris, France; Unité INSERM, Paris 7 CART : carcinose angiogenèse et recherche translationnelle, hôpital Lariboisière, chirurgie digestive et cancérologique, 2, rue Ambroise-Paré, 75010 Paris, France.
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11
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Di Fabio F, Aston W, Mohamed F, Chandrakumaran K, Cecil T, Moran B. Elevated tumour markers are normalized in most patients with pseudomyxoma peritonei 7 days after complete tumour removal. Colorectal Dis 2015; 17:698-703. [PMID: 25704482 DOI: 10.1111/codi.12924] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 12/31/2014] [Indexed: 12/28/2022]
Abstract
AIM Elevation of the preoperative tumour markers in pseudomyxoma peritonei (PMP) is common and is a risk factor for recurrence. There has, however, been no documentation of the effect of complete tumour removal on tumour markers levels after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of the study was to compare the tumour markers 7 days after surgery in patients with elevated preoperative levels. METHOD This was an observational prospective study of patients with PMP of appendiceal origin treated in one of the UK National Referral Centres for this condition. Thirty patients [median age = 61 (range: 31-74) years; six men] with an elevated preoperative level of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA-125) and/or carbohydrate antigen 19-9 (CA19-9) underwent repeated estimation, 7 days after CRS and HIPEC for PMP. RESULTS The median preoperative CEA level of 12 μg/l fell to 0.75 μg/l postoperatively (P < 0.0001), CA-125 fell from 45 to 31 kU/l (P = 0.183) and CA19-9 fell from 134 to 37 kU/l (P = 0.003). The CEA was raised in 22 (73%) of 30 patients preoperatively and in two (7%) of 30 patients 7 days after surgery (P < 0.0001). The corresponding data for CA-125 were 18 (60%) and 13 (43%) (P = 0.196) and for CA19-9 they were 24 (80%) and 16 (53%) (P = 0.028). CONCLUSION This is the first documentation of a reduction or normalization of CEA 7 days after CRS, but not for CA19-9 or CA-125. This may indicate completeness of surgical resection and could aid selection for adjuvant therapy and predict prognosis. Long-term follow-up is, however, necessary to determine the significance of this observation.
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Affiliation(s)
- F Di Fabio
- Peritoneal Malignancy Institute and Colorectal Surgery, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
| | - W Aston
- Peritoneal Malignancy Institute and Colorectal Surgery, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
| | - F Mohamed
- Peritoneal Malignancy Institute and Colorectal Surgery, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
| | - K Chandrakumaran
- Peritoneal Malignancy Institute and Colorectal Surgery, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
| | - T Cecil
- Peritoneal Malignancy Institute and Colorectal Surgery, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
| | - B Moran
- Peritoneal Malignancy Institute and Colorectal Surgery, Basingstoke and North Hampshire Hospitals, Basingstoke, UK
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Abstract
Until recently, a diagnosis of peritoneal carcinomatosis was uniformly accompanied by a grim prognosis that was typically measured in weeks to months. Consequently, the management of carcinomatosis revolves largely around palliation of symptoms such as bowel obstruction, nausea, pain, fatigue, and cachexia. A prior lack of effective treatment options created the nihilistic view that currently exists and persists despite improvements in the efficacy of systemic therapy and the evolution of multimodality approaches including surgery and intraperitoneal chemotherapy. This article reviews the evolution and current state of treatment options for patients with peritoneal carcinomatosis. In addition, it highlights recent advances in understanding the molecular biology of carcinomatosis and the focus of current and future clinical trials. Finally, this article provides practical management options for the palliation of common complications of carcinomatosis. It is hoped that the reader will recognize that carcinomatosis is no longer an imminent death sentence and that through continued research and therapeutic innovation, clinicians can make an even greater impact on this form of metastatic cancer.
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Affiliation(s)
- Laura A Lambert
- Associate Professor, Division of Surgical Oncology, Division of Palliative Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA
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13
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Spyropoulos C, Rentis A, Alexaki E, Triantafillidis JK, Vagianos C. Appendiceal mucocele and pseudomyxoma peritonei; the clinical boundaries of a subtle disease. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:355-60. [PMID: 25163976 PMCID: PMC4156334 DOI: 10.12659/ajcr.890837] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Patient: Male, 70 • Male, 84 Final Diagnosis: Appendiceal mucocele and pseudomyxoma peritonei Symptoms: — Medication: — Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
| | - Achilleas Rentis
- 3rd Department of Surgery, IASO General Hospital, Athens, Greece
| | - Eleftheria Alexaki
- 3rd Department of Internal Medicine, Gennimatas General Hospital, Athens, Greece
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