Number: | 27ESURABS0058 |
Type: | Educational Electronic Presentation |
Authors: | Samantha Fossey, Faye Cuthbert |
Keywords: | periton*, carcinomatosis |
Introduction:
Primary serous peritoneal cancer (PPC) is a rare epithelial tumour that arises in the peritoneum and is thought to arise from extraovarian mesothelium that has Mullerian potential. PPC is histologically identical to surface epithelial ovarian cancer (which accounts for 90% of ovarian cancer) because tumour cells lie on the surface of the ovary or fallopian tubes and slough off and enter the peritoneal circulation. [1,2]
Peritoneal carcinomatosis can also result from metastatic spread of tumours from: the GI tract, ovary, lung, breast and uterus. Peritoneal disease can be seen in other benign conditions, therefore careful imaging assessment is paramount, and biopsy can profoundly alter management. [3]
The purpose of our educational exhibit is to:
Summarise and illustrate -
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The normal circulation of peritoneal fluid within the abdominal cavity and its regions of stasis
The peritoneum is a thin, translucent serosal membrane that covers the surface of the peritoneal cavity and its mesenteries. It’s purpose is to provide a surface over which the viscera can move, and as a site of fluid transport. [3]
Malignant cells are carried by peritoneal fluid throughout the abdomen and pelvis resulting in widespread metastases. The fluid follows a predictable circulation pathway from the pelvis to the diaphragm that is defined by the reflections of the peritoneum. [3]
Peritoneal fluid can flow upward from the pelvis due to pressure gradients in the abdomen which increase during inspiration (FIG 1). There are dependent recesses where the flow of...
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Peritoneal disease in women is not necessarily due to ovarian cancer, and imaging should be carefully assessed to look for clues in the differential. Imaging appearances of peritoneal carcinomatosis are predictable but can be diagnostically challenging because of its mimics. It is important to consider potential alternatives and biopsy, as optimal management differs with histology.
References
[1] Levy, A. Arnaiz, J. Shaw, J. et al. Primary Peritoneal Tumors: Imaging Features with Pathologic Correlation. Radiographics 2008;28:583-607.
[2] Pannu, H. Bristow, R. Montz, F. et al. Multidetector CT of Peritoneal Carcinomatosis from Ovarian Cancer.RadioGraphics 2003; 23:687–701
[3] Levy, A. Shaw, J. Sobin, L. Secondary Tumors and Tumorlike Lesions of the Peritoneal Cavity: Imaging Features with...
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