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Case Reports
. 2023 Oct 16:11:696.
doi: 10.12688/f1000research.110362.2. eCollection 2022.

Case Report: Incidental discovery of primary peritoneal psammocarcinoma

Imen Helal  1   2 , Fatma Khanchel  1   2 , Raja Jouini  1   2 , Maissa Ben Thayer  1   2 , Chaouki Mbarki  2   3 , Hajer Bettaieb  2   3 , Saber Rebii  2   4 , Imen Ben Ismail  2   4 , Ehsen Ben Brahim  1   2 , Aschraf Chedli-Debbiche  1   2
Affiliations
Case Reports

Case Report: Incidental discovery of primary peritoneal psammocarcinoma

Imen Helal et al. F1000Res. .

Abstract

Psammocarcinoma is an uncommon subtype of low-grade serous carcinoma. It is characterized by the presence of extensive psammoma bodies and can have either an ovarian or peritoneal origin. To our knowledge fewer than 30 cases of primary peritoneal psammocarcinoma (PPP) have been reported in the English literature. We report a rare case of PPP in a 74-year-old female, discovered fortuitously within a laparotomy for gallbladder lithiasis. At laparotomy, multiple nodular implants involving the omentum, the peritoneum and a magma of intestinal loops in the right iliac fossa were noted. A biopsy from nodules was performed. Gross examination showed multiple nodules of different sizes in the fat tissue. Pathologic examination showed massive psammoma bodies representing more than 75% of the tumor. The final diagnosis was psammocarcinoma. Our patient was referred to the gynecologic department for further investigation and to ascertain whether the tumor arose from the ovaries or peritoneum. Hysterectomy, bilateral adnexectomy and omentectomy were performed. Macroscopic examination showed that both ovaries were intact having a normal size. No invasion of ovarian stroma was shown in microscopic examination. The patient died of SARS-CoV-2 (COVID-19) six days after the surgery. PPP is a rare type of low-grade serous carcinoma. The behavior of this tumor is unclear, and the treatment is not standardized because of its rarity and lack of long-term follow-up. More cases need to be studied for better understanding and improvement of the management protocols.

Keywords: Primary peritoneal psammocarcinoma; case report; psammocarcinoma; psammomatous bodies; serous carcinoma.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Abdominal ultrasound.
The walls of the gallbladder (GB) are thickened, hyperechoic with a mobile gallstone.
Figure 2.
Figure 2.. Microscopic examination (Hematoxylin and eosin staining ×40).
Numerous psammoma bodies with small epithelial nests (see arrows) invading the peritoneum.
Figure 3.
Figure 3.. Abdominal computerized tomography scan.
Agglutination of the last ileal loops in contact with the anterior abdominal wall (see arrow), infiltration of the mesenteric fat and multiple mesenteric lymphadenopathies.
Figure 4.
Figure 4.. Macroscopic examination showed both ovaries with the circles indicating the normal size.
See this image and copyright information in PMC

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