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Pseudomyxoma Peritonei

Yeqian Huang, Nayef A Alzahrani, Winston Liauw, Thamer B Traiki, David L Morris
BACKGROUND: There is little evidence for the use of early postoperative intraperitoneal chemotherapy (EPIC) in patients with low-grade appendiceal mucinous neoplasms (LAMNs) with pseudomyxoma peritonei (PMP). This study aims to assess the outcomes regarding the use of EPIC in a large cohort of patients with LAMNs with PMP uniformly treated by cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC), all of whom received hyperthermic intraperitoneal chemotherapy (HIPEC), and most of whom also received EPIC...
October 7, 2016: Annals of Surgical Oncology
Byeong-Joo Noh, Youn Wha Kim, Yong-Koo Park
Heterotopic ossification occurring to low-grade appendiceal mucinous neoplasm (LAMN) (pseudomyxoma peritonei) is extremely rare. The pathogenetic mechanism of the tumor-related heterotopic bone formation remains as yet unconfirmed. Here, we describe a rare case of LAMN with ossification in a 72-year-old woman, and concentrate on the etiology of heterotopic ossification by the immunohistochemical evaluation of the novel markers such as BMP9, osteocalcin, and osteopontin. BMP9 is one of the most effective osteogenetic proteins...
September 22, 2016: Pathology, Research and Practice
Ahmed Mostafa Ahmed Mahmoud, Marwa Mahmoud Hussein, Manar Mohamed Moneer
BACKGROUND: For a long time peritoneal neoplasms were considered beyond surgical intervention and beyond cure, till the concept of cytoreductive surgery (CRS) and adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) was introduced. However this surgical intervention is technically demanding and associated with considerable postoperative morbidity. OBJECTIVE: To describe the surgical strategy in resection of critical sites loaded by heavy tumor deposits and to evaluate short and long term results of CRS and HIPEC, in a cohort of Egyptian patients with pseudomyxoma peritonei (PMP) from appendiceal origin...
September 19, 2016: Journal of the Egyptian National Cancer Institute
Priyanka Punit Kedia, Gayatri Ravikumar, Suravi Mohanty, Julian Crasta, Elizabeth Vallikad
BACKGROUND: Pseudomyxoma peritonei (PMP) is a rare and poorly understood clinicopathological entity characterized by gelatinous ascites with neoplastic or non-neoplastic mucinous implants in the peritoneum. Although its origin was debated, current evidence in literature favours the appendix as the origin of the disease, over the ovaries. The changing terminologies in the classification of this entity pose diagnostic and management challenges. CASE REPORTS: Herein, we report three cases of PMP in postmenopausal women, their clinical presentation, pathological staging based on the peritoneal tumor deposits and the treatment administered...
October 2016: Journal of Obstetrics and Gynaecology of India
J-B Delhorme, C Honoré, L Benhaim, F Dumont, P Dartigues, C Dromain, M Ducreux, D Elias, D Goéré
INTRODUCTION: Complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have dramatically changed the prognosis of patients with pseudomyxoma peritonei (PMP). However, recurrences can still occur and no consensus has been reached regarding their optimal treatments. This study aimed to analyze the patterns of recurrence after CCRS plus HIPEC for PMP and potential subsequent treatments of these lesions. PATIENTS AND METHODS: Between 1992 and 2014, patients who had relapsed after treatment of PMP were selected from a prospective database of 251 patients who had undergone CCRS plus HIPEC with a curative intent...
September 2, 2016: European Journal of Surgical Oncology
Philipp Horvath, Stefan Beckert, Florian Struller, Alfred Königsrainer, Ingmar Königsrainer
AIM: To investigate the clinical impact of post-hyperthermic intraperitoneal chemotherapy (HIPEC) leukopenia, intraperitoneal and combined intravenous/intraperitoneal drug administrations were compared. METHODS: Two patient cohorts were retrospectively analyzed regarding the incidence of postoperative leukopenia. The first cohort (n = 32) received Mitomycin C (MMC)-based HIPEC intraperitoneally (35 mg/m² for 90 min) and the second cohort (n = 10) received a bi-directional therapy consisting of oxaliplatin (OX) (300 mg/m(2) for 30 min) intraperitoneally and 5-fluorouracil (5-FU) 400 mg/m² plus folinic acid 20 mg/m² intravenously...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
F Pietrantonio, F Perrone, A Mennitto, E M Gleeson, M Milione, E Tamborini, A Busico, G Settanni, R Berenato, M Caporale, F Morano, I Bossi, A Pellegrinelli, M Di Bartolomeo, F de Braud, D Baratti, W B Bowne, S Kusamura, M Deraco
BACKGROUND: Outcome of pseudomyxoma peritonei (PMP) after cytoreductive surgery (CRS) and hypertermic intraperitoneal chemotherapy (HIPEC) is heterogeneous even after adjusting for clinico-pathological prognostic variables. The identification of additional prognostic or even predictive biomarkers is an unmet clinical need. PATIENTS AND METHODS: Forty patients with mucinous appendiceal tumors and PMP were clinically eligible and had evaluable tumor samples obtained after CRS and HIPEC...
August 8, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Alexandre Balaphas, Valentina Belfontali, Frédéric Ris, Andreas Lanitis, Raphael P H Meier, Marie-Laure Amram, Arnaud Roth, Olivier Huber, Thierry Berney, Philippe Morel
In 2016, peritoneal carcinomatosis can be considered as a chronic disease that can be treated and sometimes cured. Hyperthermic Intra PEritoneal Chemotherapy (HIPEC) is a procedure developed in the eighties. Combined with CytoReductive (CR) surgery, this protocol underwent a considerable expansion in Washington Cancer Institute. CR combined with HIPEC was demonstrated to be the only curative treatment for PseudoMyxoma Peritonei syndrome (PMP). It is actually approved in the management of peritoneal carcinomatosis of ovarian, colorectal, or peritoneal primitive (mesothelioma) origin but is still studied for gastric cancer...
June 15, 2016: Revue Médicale Suisse
A Agrusa, G Romano, M Galia, G Cucinella, V Sorce, G Di Buono, F Agnello, G Amato, G Gulotta
INTRODUCTION: Appendiceal mucocele is a relatively rare condition characterized by progressive dilation of the appendix caused by intraluminal accumulation of mucoid substance. Its incidence is 0.07 - 0,63% of all appendectomies performed. CASE REPORT: We report the case of a 70-year-old man who came to our observation with gravative pain in right lower abdominal region. A computed tomography abdominal scan revealed a cystic/tubular structure like an appendicular mass with wall enhancement but without calcifications suggestive of a mucocele...
March 2016: Il Giornale di Chirurgia
Francesco Di Fabio, Akash Mehta, Kandiah Chandrakumaran, Faheez Mohamed, Tom Cecil, Brendan Moran
BACKGROUND: Optimal outcomes in pseudomyxoma peritonei (PMP) require complete macroscopic tumor removal by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Partial or complete gastrectomy may be required with ongoing debate as to the risks and benefits of gastrectomy in what is often a low-grade malignancy. METHODS: Retrospective single-center analysis of 1014 patients undergoing CRS and HIPEC for PMP of appendiceal origin...
July 5, 2016: Annals of Surgical Oncology
Daniel Martingano, Hashroop Gurm, Andrew Oliff, Francis X Martingano, George Aglialoro
The fifth leading cause of cancer-related deaths among women in the United States is ovarian cancer. An estimated 21,980 new cases and 14,270 estimated deaths occurred nationwide in 2014. More than two-thirds of cases of ovarian cancer are diagnosed at stage III or IV when the peritoneal cavity or other organs are affected. Primary appendiceal malignant neoplasms may mimic advanced-stage ovarian cancer and can be misdiagnosed because of its presentation as a palpable adnexal mass. The authors describe a 42-year-old woman who was admitted to the department of obstetrics and gynecology to receive treatment for presumed advanced-stage ovarian cancer...
July 1, 2016: Journal of the American Osteopathic Association
Dario Baratti, Shigeki Kusamura, Massimo Milione, Filippo Pietrantonio, Marta Caporale, Marcello Guaglio, Marcello Deraco
BACKGROUND: Pseudomyxoma peritonei (PMP) usually originates from appendiceal neoplasms and, less commonly, from extra-appendiceal lesions. To date, the clinical and therapeutic implications of extra-appendiceal origin are largely unknown. METHODS: A prospective database of 225 PMP patients uniformly treated by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) was reviewed to identify cases with extra-appendiceal primaries. Histologically, negative appendix defined extra-appendiceal origin...
June 28, 2016: Annals of Surgical Oncology
Guillaume Passot, Bradford J Kim, Delphine Vaudoyer, Vahan Kepenekian, Isabelle Bonnefoy, Naoual Bakrin, Eddy Cotte, Olivier Glehen
BACKGROUND: Complete cytoreductive surgery (CRS), combining organ resection and peritonectomy, is the only treatment that could offer cure for patients with peritoneal carcinomatosis. Initially, when the Glisson's capsule was involved without deep liver parenchyma invasion, either electroevaporation or Glisson's capsule resection was proposed. The objective of this study is to present and evaluate the safety of this standardized digital glissonectomy. METHODS: Since 2009, the peritonectomy of the Glisson's capsule, or digital glissonectomy, has been standardized at our institution...
June 24, 2016: Annals of Surgical Oncology
J Spiliotis, E Halkia, E de Bree
Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locoregional treatment for selected patients with ptc from gastric, colorectal, and ovarian cancer; with mesothelioma; and with pseudomyxoma peritonei...
June 2016: Current Oncology
Y Liu, A Mizumoto, H Ishibashi, K Takeshita, M Hirano, M Ichinose, S Takegawa, Y Yonemura
BACKGROUND: This study aims to evaluate the safety and efficacy of cytoreductive surgery (CRS) including total gastrectomy and total colectomy in selected pseudomyxoma peritonei (PMP) patients with entire stomach and colon covered by mucinous tumor. METHODS: A total of 48 patients received this extensive treatment between January 2006 and January 2014. The main focus of this study was survival after CRS as well as perioperative morbidity and mortality. RESULTS: Twenty-eight patients were male, and median age was 52...
July 2016: European Journal of Surgical Oncology
Romeo Ioan Chira, Codrut Cosmin Nistor-Ciurba, Andreea Mociran, Petru Adrian Mircea
Pseudomyxoma peritonei (PMP) is a rare disease, caused by primary mucinous tumors that arise most frequently from appendix, ovary, or pancreas. Usually diagnosis is made by computed tomography, but ultrasonography can be a very useful imagistic method, if this diagnosis is taken into account by the observer. We present a case of a PMP caused by an appendiceal mucinous carcinoma, in a 34-year-old male patient, with family history of malignancies, diagnosed in our department. He was thereafter surgically treated - appendiceal resection, peritoneal lavage - followed by chemotherapy...
June 2016: Medical Ultrasonography
Manika Agarwal, Ritesh Kumar, Noor Topno, Shweta Mishra, Ashish Dhirasaria, A Santa Singh
Advanced mucinous ovarian cancer is a separate entity and has different biological behaviour. There is a wide range of therapeutic challenges and dilemmas in the management of these patients. The authors present a case of advanced ovarian mucinous cystadenocarcinoma with pseudomyxoma peritonei who had poor response to standard neoadjuvant chemotherapy. This case is highlighted to emphasize the challenges in the decision making for the management of advanced mucinous ovarian cancer.
April 2016: Indian Journal of Palliative Care
Filippo Pietrantonio, Rosa Berenato, Claudia Maggi, Marta Caporale, Massimo Milione, Federica Perrone, Elena Tamborini, Dario Baratti, Shigeki Kusamura, Luigi Mariani, Monica Niger, Alessia Mennitto, Annunziata Gloghini, Ilaria Bossi, Giulio Settanni, Adele Busico, Pietro Francesco Bagnoli, Maria Di Bartolomeo, Marcello Deraco, Filippo de Braud
BACKGROUND: There is lack of evidence about systemic treatment of pseudomyxoma peritonei (PMP) relapsing after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. There is also lack of biomarkers able to predict outcomes beyond known clinical and pathological prognostic features. METHODS: Fifteen patients with relapsed PMP and progressive disease within the last 6 months were included and received metronomic capecitabine (625 mg/mq/day b.i.d.) and bevacizumab (7...
2016: Journal of Translational Medicine
Adrian Cravioto-Villanueva, Magdalena Cavazos, Pedro Luna-Perez, Hector Martinez-Gomez, María Lourdes Ramirez, Juan Solorzano, Hermelindo Montiel, Jesus Esquivel
BACKGROUND AND PURPOSE: The long-term survival of patients with peritoneal carcinomatosis of colorectal origin has been achieved with cytoreductive surgery, which removes all macroscopic implants, combined with hyperthermic intraperitoneal chemotherapy (HIPEC). The current technology for administering intraperitoneal heated chemotherapy is expensive and, for some institutions, unaffordable. We conducted this study to assess the temperature stability provided by a modified, inexpensive system, to offer a simple and low cost alternative to the standard HIPEC delivery equipment...
August 2016: Surgery Today
N Ansari, K Chandrakumaran, S Dayal, F Mohamed, T D Cecil, B J Moran
PURPOSE: To report early and long term outcomes following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in 1000 patients with perforated appendiceal epithelial tumours, predominantly with pseudomyxoma peritonei (PMP). METHODS: Retrospective analysis of a prospective database of 1000 consecutive patients undergoing CRS and HIPEC for perforated appendiceal tumours between 1994 and 2014 in a UK National Peritoneal Malignancy unit...
July 2016: European Journal of Surgical Oncology
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