A Case of Pseudomyxoma Peritonei Diagnosed Concomitant with a Gastric Cancer

Manabu Emi, Kazuto Jinushi and Ryou Sumimoto

Department of Surgical Oncology, Mihara Medical Association Hospital

A 54-year-woman, with elevated CEA and undergoing gastrointestinal endoscopy was found to have a type 5 tumor on the lesser curvature of the lower stomach. Abdominal computed tomography (CT) showed continuous small cystic tumors in the lower abdominal cavity. We conducted laparotomy on suspicion of dissemination of gastric cancer or pseudomyxoma peritonei, but could not definitively diagnose the case during sugery. We then conducted distal gastrectomy and B-II reconstruction. Pathological diagnosis showed disseminated gastric cancer, but clinical findings showed a strong possibility of pseudomyxoma peritonei, leading to resection of the cystic tumor plus appendectomy, omentectomy, and partial resection of the transverse colon. We situated a subcutaneous implant-reservoir was sited intraperitoneally for postoperative chemotherapy. The resected specimen showed pseudomyxoma peritonei arising in the appendix. Intraperitoneal chemotherapy involved CDDP and MMC was performed for three times. Daily oral administration of 1,200 mg of 5'DFUR was started 11 months after surgery because of slightly elevated CEA, but the patient is doing well without signs of recurrence as of 30 months after the initial laparotomy.

Key words
pseudomyxoma peritonei, intraperitoneal chemotherapy

Reprint requests
Manabu Emi Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University
1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 JAPAN

Accepted
February 22, 2006

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