[Pseudomyxoma peritonei. Two-case-report].

BACKGROUND: Pseudomyxoma peritonei is a disease characterized by an intraperitoneal adenomucinous tumor cell disemination, being cecal appendix the most common etiology.

OBJECTIVE: To report a surgeon's group experience and a detailed up to date literature review.

CLINICAL CASES: 1. A 74 year old woman with a history of four days with mesogastrium and right lower quadrant abdominal pain associated with diarrhea and fever was admitted to our institution. Upon admission she presented with signs of peritoneal irritation and muscular rigidity, leukocytosis of 14,500 cels/mm(3), 89% neutrophils and 1% bands. An acute appendicitis diagnosis was established, being scheduled for diagnostic laparoscopy, during procedure, significant bowel distention was found, so conversion to laparotomy was required. Case 2. A 73 year old male with a history of one year with intermittent abdominal pain at right iliac fossa and hypogastrium was admitted to our institution. Dyspnea, constipation alternating with periods of diarrhea, gastric fullness and heartburn occurred. On physical examination only a palpable tumor occupying mesogastrium and both iliac fossae was noticed, therefore, a laparotomy was performed. In both cases diagnoses were made during procedure, finding multiple scattered multilobulated mucinous tumor implants within the peritoneal cavity. Histopathological studies confirmed a pseudomyxoma peritonei diagnoses.

CONCLUSIONS: Peritoneal pseudomyxoma is a rare malignant tumor with a difficult diagnosis characterized by copious production of mucinous ascites and multiple tumors implants on serosa of intracavitary viscera. The gold standard treatment consists of cytoreductive surgery and perioperative intraperitoneal chemotherapy and/or adjuvant chemotherapy.