eISSN: 2299-0038
ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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SCImago Journal & Country Rank
 
3/2021
vol. 20
 
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abstract:
Case report

Pseudomyxoma peritonei of appendiceal origin mimicking ovarian cancer – a case report with literature review

Stoyan Kostov
1
,
Yavor Kornovski
2
,
Stanislav Slavchev
2
,
Yonka Ivanova
2
,
Deyan Dzhenkov
3
,
Angel Yordanov
4
,
Svetoslava Slavcheva
5

1.
Department of Gynecology, UMHAT “Saint Anna”, Varna, Bulgaria
2.
Department of Gynecology, Medical University Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria
3.
Department of General and Clinical Pathology, Forensic Medicine and Deontology, Division of General and Clinical Pathology, Faculty of Medicine, Medical University Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria
4.
Department of Gynecologic Oncology, Medical University Pleven, Pleven, Bulgaria
5.
Department of First Cardiology Clinic, UMHAT “Saint Anna”, Varna, Bulgaria
Menopause Rev 2021; 20(3): 148-153
Online publish date: 2021/09/13
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Pseudomyxoma peritonei (PMP) is a rare and uncommon condition, characterized by the presence of mucinous ascites in the abdominal cavity. The most common cause of PMP is mucinous adenocarcinoma of the appendix, followed by neoplasms of the ovary, endocervix, fallopian tube, alimentary organs, urachus, urinary bladder, lung, mucinous cyst of the spleen, and breast.

Herein, we report a case of a 64-year-old postmenopausal woman (gravida 2, para 2) who presented at the department of gynecology with a short history of nausea and abdominal distention. Abdominal and vaginal ultrasonography showed a large amount of free fluid in the pelvis with hyperechoic echogenicity and right pelvic tumor with mixed echogenicity. Computed tomography demonstrated the presence of a heterogeneous, hypodense mass, without contrast enhancement, located on the right side of the pelvis, near the right ovary. Laparotomy was performed. Revision of the abdominal cavity revealed a large amount of yellow gelatinous mucinous ascites – approximately 1.5 l. A tumor (6 x 7 cm in diameter), arising from the appendix and located in the pouch of Douglas near the right ovary, was observed. Histopathology examination revealed poorly differentiated mucinous appendiceal adenocarcinoma, comprising up to 50% signet ring cells.

Gastrointestinal tumors such as appendiceal neoplasms combined with PMP may mimic ovarian carcinomas. Computed tomography, abdominal/vaginal ultrasonography and tumor marker levels (carcino-embryonic antigen, carbohydrate antigen 19.9, carbohydrate antigen Ca-125) may establish the diagnosis.

A differential diagnosis with appendiceal tumors should be considered for patients with right pelvic masses.
keywords:

appendiceal neoplasm, pseudomyxoma peritonei, ovarian tumors, mucin, appendectomy

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