In pursuit of the primary

Abstract

Extraovarian primary peritoneal carcinoma (EOPPC) is a rare tumour of the peritoneum that shares many features with serous ovarian carcinoma because of a common embryological origin. We report a case of EOPPC presenting with a malignant pleural effusion. https://bit.ly/3GMuKgL.

Figure 1

Portable chest radiograph showing a large, right-sided pleural effusion causing a shift of the mediastinum to the left side.

Figure 2

a) Cellular smear made up of three-dimensional clusters of atypical hyperchromatic cells (Papanicolaou stain, 4× magnification). b) Higher magnification revealed a papillaroid cell cluster with pleomorphic darkly stained nuclei (Papanicolaou stain, 20× magnification). c) Smear showing papillaroid clusters of neoplastic cells (May Grunwald-Giemsa stain, 10× magnification). d) Higher magnification revealed neoplastic cells with high nuclear/cytoplasmic ratio, irregular nuclear membrane and some of the nuclei with prominent nucleoli (May Grunwald-Giemsa stain, 40× magnification).

Figure 3

FDG PET-CT image showing increased uptake in the pelvic peritoneum and omentum.

Figure 4

a) Section from small bowel mesentery showing tumour cells in an acinar pattern (May Grunwald-Giemsa stain, 40× magnification). b) Section from left paracolic gutter peritoneum showing tumour nodules in nests (May Grunwald-Giemsa stain, 40× magnification). c) Section from the left ovary showing normal ovarian stroma (May Grunwald-Giemsa stain, 10× magnification).