Pseudomyxoma peritonei.

摘要

A 64-year-old man presented with 3-month history of increasing abdominal girth, anorexia with postprandial nausea and a weight loss of 6 kg. He had undergone appendectomy because of a tumor of appendix approximately 10 years ago. He was lost to follow-up and was free of symptoms. Physical examination showed a huge hard palpable mass in a distended abdomen with dullness to percussion. Laboratory tests showed slight anemia (hemoglobin: 10.4 g/dL) and hypoalbuminemia (albumin 3.0 g/dL). Serum carcinoembryonic antigen level was 10,716 ng/mL. Abdominal echogram showed multiple heterogeneous masses occupying in anterior abdomen and minimal ascites. Computed tomography of the abdomen showed multiple, septate, soft tissue masses scattered over the liver surface, omentum and mesentery with compression of liver margin and small and large bowel lumen (Figure 1). At exploratory laparotomy, widespread unre-sectable intra-abdominal jelly-like tumors coating the bowel and peritoneum were discovered. Pathologic examination showed well-differentiated mucin-containing tumor cells set in mutinous pools (Figure 2). Pseudomyxoma peritonei secondary to ruptured appendical mutinous adenocarcinoma was diagnosed.