Role of imaging in pseudomixoma peritonei

Congress:

ECR 2020

Poster Number:

C-15263

Type:

Educational Exhibit

Keywords:

Oncologic Imaging, Abdomen, Gastrointestinal tract, Peritoneum, CT, MR, Ultrasound, Diagnostic procedure, Metastases, Not applicable

Authors:

C. Sofia, M. A. Marino, A. Cattafi, A. Macri', G. Ascenti, A. Blandino; Messina/IT

DOI:

10.26044/ecr2020/C-15263

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-15263

Table 1

Fig. 2: Clinical presentation of PMP.

Fig. 3: B-mode US image: the arrow indicates the mucinous-filled vermiform appendix.

Fig. 4: B-mode US image: the arrow shows mucinous ascites containing punctuate echoes.

Learning objectives

To show the main features of pseudomyxoma peritonei in different imaging modalities.

Background

Pseudomyxoma peritonei (PMP) is a progressive disease characterized by gelatinous peritoneal deposits (the so called “Jelly Belly”). The estimated incidence of PMP is of 1-3 out a million per year and it is usually incidentally discovered in people with ages between 40-55 undergoing imaging for other reasons [1]. It is considered to originate from a mucinous appendicular neoplasia. The key event is the perforation or rupture of the neoplastic appendicular mucocele into the peritoneal cavity [2]. The mucinous material spreads following the peritoneal fluid flow...

Findings and procedure details

Imaging is pivotal for detection and preoperative planning of PMP. Ultrasound is valuable for the evaluation of the appendicular region: an abnormal fluid distension of the vermiform appendix lumen is suspicious for mucocele (Fig.3). Ascites containing septa, motionless punctuate echoes and floccules into mucinous ascites, honeycomb like lesions, visceral organs surface notches (scalloping) are also recognizable at US examination (Fig.4) [10-11]. CT and MRI represent not only sensitive mapping techniques for proper presurgical planning but also for the staging PMP. Both imaging modalities allow to...

Conclusion

The knowledge of the typical imaging features and sites of the disease are paramount for recognizing and staging pseudomyxoma peritonei allowing a proper individually tailored treatment of the patient.

Personal information and conflict of interest

C. Sofia; Messina/IT - nothing to disclose M. A. Marino; Messina, ME/IT - nothing to disclose A. Cattafi; Messina/IT - nothing to disclose A. Macri'; Messina/IT - nothing to disclose G. Ascenti; Messina/IT - nothing to disclose A. Blandino; Messina/IT - nothing to disclose Carmelo Sofia Department of Biomedical Sciences and Morphologic and Functional Imaging, University of Messina, Messina, Italy [email protected]

References

1.Syed Ali Rizvi, Wajahat Syed, and Ravi Shergill. Approach to pseudomyxoma peritonei. World J Gastrointest Surg. 2018 10(5): 49– 56. 2.Amini A, Masoumi-Moghaddam S, Ehteda A et al. Secreted mucins in pseudomyxoma peritonei: pathophysiological significance and potential therapeutic prospects. Orphanet Journal of Rare Diseases 2014, 9:71 3.Ronnett BM, Zahn CM, Kurman RJ,et al. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”Am J Surg Pathol.1995; 19:1390–1408....