Season 9 Case 11

Hx: abdominal distention

Answer: Pseudomyxoma Peritonei

-accumulation of mucinous ascites from mucin producing tumor.

This case is the classic mucinous appendiceal tumor s/p multiple debulking surgeries!

Pseudomyxoma Peritonei

Source: mucinous tumor of appendix (#1), colon, stomach, pancreas, urachus, ovary Rupture -> mucin & neoplastic cells into the peritoneum -> diffuse peritoneal spread of malignancy and increasing abdominal distention

Pseudomyxoma Peritonei (Imaging)

US - echogenic peritoneal masses

CT - low/simple fluid locules w mass effect +/- ring calcs

->scalloping of organ surfaces and centrally displaced small bowel

MR - low T1, high T2 (follows water) +/- enhance

Pseudomyxoma Peritonei Complications:

• fibrosis + adhesions -> recurrent bowel obstructions (can be fatal)

Treatment: +surgical debulking +intraperitoneal chemotherapy