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Case Reports
. 2025 Jun 6;17(6):e85474.
doi: 10.7759/cureus.85474. eCollection 2025 Jun.

Diagnostic Pitfalls in Peritoneal Carcinomatosis: A Case of Pseudomyxoma Peritonei

Maksim Isachanka  1 , Ilya Tarasau  2 , Olga Matylevich  2 , Siarhei Mavrichev  2 , Alena Dalamanava  2 , Dmitry Rovski  2 , Aliaksei Kurchankou  3 , Mariya Galka  4 , Mikalay Kurchankou  5
Affiliations
Case Reports

Diagnostic Pitfalls in Peritoneal Carcinomatosis: A Case of Pseudomyxoma Peritonei

Maksim Isachanka et al. Cureus. .

Abstract

Pseudomyxoma peritonei (PMP) is a rare pathological condition posing significant diagnostic and management challenges. This article presents a clinical case of a 58-year-old female who was initially diagnosed with stage III primary peritoneal carcinoma. Following neoadjuvant chemotherapy, a diagnostic re-evaluation was performed with histopathological and immunohistochemical review of biopsy specimens, which led to a revised diagnosis of mucinous carcinoma with features consistent with PMP. The patient subsequently underwent complete cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). She has remained disease-free for 12 months post-operatively. This case illustrates the crucial role of pathological assessment in guiding treatment for PMP and demonstrates favorable long-term outcomes with aggressive CRS and HIPEC in appropriately selected patients.

Keywords: cytoreductive surgery; gynecologic oncology; hyperthermic intraperitoneal chemotherapy; mucinous neoplasms; pseudomyxoma peritonei.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. N. N. Alexandrov National Cancer Centre of Belarus issued approval Not Applicable. As per institutional policy overseen by the N.N. Alexandrov National Cancer Centre of Belarus, formal ethics approval is waived for single case reports where written informed consent for publication has been obtained from the patient. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CT imaging of peritoneal metastases and local fluid accumulation in the abdomen and pelvis.
Arrows (from top to bottom accordingly) indicate metastases in the small omentum, metastases in the left lateral canal, and fluid accumulation in the perisplenic space.
Figure 2
Figure 2. CT imaging of peritoneal metastases and local fluid accumulation in the abdomen and pelvis.
The arrow shows metastases in the right lateral canal.
Figure 3
Figure 3. CT imaging of peritoneal metastases and local fluid accumulation in the abdomen and pelvis.
Arrows show metastases in the greater omentum.
Figure 4
Figure 4. CT imaging of peritoneal metastases and local fluid accumulation in the abdomen and pelvis.
Multiplanar reconstruction in the coronal plane. Arrows show metastases in the greater omentum.
Figure 5
Figure 5. Tumor conglomerate in the pelvis.
Figure 6
Figure 6. ALT level dynamics over a 14-day period.
ALT: Alanine transaminase
Figure 7
Figure 7. AST level dynamics over a 14-day period.
AST: Aspartate aminotransferase
Figure 8
Figure 8. Dynamics of serum urea levels in the patient during a 14-day period.
Figure 9
Figure 9. Dynamics of serum creatinine levels in the patient during a 14-day period.
Figure 10
Figure 10. Masses of cell-free mucin on the serous membrane of the fallopian tube.
Hematoxylin and eosin staining, ×10 magnification.
Figure 11
Figure 11. The focus of tumor growth on the ovarian capsule with intussusception deep into the parenchyma.
Hematoxylin and eosin staining, ×10 magnification.
Figure 12
Figure 12. Tumor growth on the serous membrane of the appendix.
Hematoxylin and eosin staining, ×10 magnification.
Figure 13
Figure 13. The focus of tumor growth in the large omentum.
Hematoxylin and eosin staining, x20 magnification.
Figure 14
Figure 14. The tumor is represented by lakes of extracellular mucus with free-lying layers of tumor cells with signs of moderate cytological atypia.
Hematoxylin and eosin staining, ×10 magnification.
Figure 15
Figure 15. The focus of infiltrating growth (peritoneum of the Morrison pocket), represented by angular glands with a perifocal desmoplastic stroma reaction.
Hematoxylin and eosin staining, ×20 magnification.
See this image and copyright information in PMC

References

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