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PubMedDate not supplied

Extragenital mixed heterologous tumor of Müllerian type arising in the cecal peritoneum: report of a case.

A mixed heterologous tumor of müllerian type arising in the cecal serosa of an elderly woman is reported. There was no history of endometriosis, and no evidence of the latter was found in the surgical specimen or at autopsy. Evidence of mesothelial origin was found microscopically in the adjacent cecal peritoneum. A review of medical literature on mixed heterologous tumors of müllerian type reveals that heretofore they have originated only in the genital system.

Aged↗
PubMedDate not supplied

The resorption of FITC-dextran 10,000 from the peritoneum in different modifications of bile-induced acute pancreatitis and in bacterial peritonitis.

The resorption from the peritoneum of fluorescein-isothiocyanate-conjugated (FITC) dextran with a mol wt of 10,000 was studied after 6, 15, and 24 h in rats with (1) only laparotomy (LC), (2) bacterial peritonitis (BP), (3) bile-induced acute pancreatitis (AP), (4) acute pancreatitis induced with contaminated bile (AIP), and (5) cerulein administration during acute pancreatitis (CAP). Animals in the AIP and CAP groups had a significantly higher mortality rate at 24 h and higher hematocrit at 6 h, indicating severe disease in these animals. At 6 and 15 h, all groups displayed similar peritoneal resorption. After 24 h, all groups with active inflammation showed significantly higher resorption than laparotomy controls. We conclude that peritoneal resorption as defined is independent of the severity and mode of induction of acute experimental pancreatitis and that it is the same as in bacterial peritonitis.

Acute Disease↗
PubMed2000

Papillary serous carcinoma of the peritoneum: analysis of clonality of peritoneal tumors.

Papillary serous carcinoma of the peritoneum (PSCP) is a primary neoplasm of peritoneal origin, and is histologically difficult to differentiate from papillary serous carcinoma of the ovary (PSCO). PSCP is frequently accompanied by many peritoneal tumors, and has been managed as a disseminated disease. In previous reports, however, the clonality of the tumors has not been fully discussed. Recently, the significant roles of the p53 and BRCA1 genes in PSCP have been reported. In this study, we investigated immunohistochemical staining for p53 proteins, and investigated p53 gene mutations, using DNA sequencing analysis, to clarify the clonality of PSCP tumors. Immunohistochemically, all the tumor samples demonstrated nuclear overexpression of p53 proteins, and the DNA sequencing analysis of the p53 gene showed diverse point mutations at codons 167 and 192 in two of four anatomically different tumors. In conclusion, the possibility of polyclonality of PSCP tumors is suggested.

Aged↗
PubMed2006

Papillary serous carcinoma of peritoneum: presentation of 2 cases.

Papillar serous carcinoma of peritoneum (PSPC) is an unfrequent neoplasm, histologically similar to papillar serous carcinoma of ovarium. It presents as peritoneal carcinomatosis without evident tumoral focus. Management of PSPC is similar to ovaric neoplasms, although prognosis should be worse. Long-term survival has been described with cytoreductive surgery and adjuvant chemotherapy with platinum. We present hereby 2 cases of PSPC.

Aged↗
PubMed1977

Papillary tumors of the peritoneum in women: mesothelioma or papillary carcinoma.

It has been urged recently that the surface tumors of the ovary be classified as mesotheliomas because both of these neoplasms have a common ancestry. It was suggested also that the rare extragonadal peritoneal tumor of a microscopic morphology similar to that of the ovarian tumor be considered as a mesothelioma. In the present report, objections to this classification are offered. Fifteen cases of diffuse and/or localized peritoneal tumors interpreted as papillary carcinoma arising from extraovarian tissue of Müllerian potentiality are described, and distinctions from mesothelioma are pointed out. Reasons for opposing the grouping of ovarian carcinoma or extragonadal papillary carcinoma of the peritoneum with mesothelioma include the need for categorizing the latter separately in order to monitor its association with asbestos exposure and the possibility that biological differences between these tumors may lead to the development of different modes of therapy.

Adult↗
PubMed1992

Scanning electron microscopy of endometriotic lesions in the pelvic peritoneum and the histogenesis of endometriosis.

OBJECTIVE: To determine whether the epithelium of an endometriotic lesion has eutopic endometrial glandular epithelium morphology or not for the histogenesis of endometriosis. METHOD: Scanning electron microscopy (SEM) of the endometrium was done for 25 cases. Histologically proven endometriotic lesions of 10 of these 25 cases were processed for SEM. Peroneum samples of another 15 cases without histological endometriosis were also studied. RESULT: Three of 10 cases with histologically proven endometriotic lesions revealed endometrium-like morphology by SEM, whereas normal appearing peritoneum without histological endometriosis in 15 cases showed no endometrium-like structures by SEM. CONCLUSION: Although abovementioned results did not support retrograde menstruation and implantation, they suggested a possibility of derivation from the endometrium.

Adult↗
PubMed1986

Enterobius (Oxyuris) vermicularis of the pelvic peritoneum--a cause of infertility.

A case of Enterobius (Oxyuris) vermicularis granulomatous disease of the pelvic peritoneum causing pelvic adhesions and infertility is presented and discussed. Since parasitic diseases are common in the developing countries, the infertility team has to bear in mind that a parasitic disease might be the main cause of infertility.

Adult↗
PubMed1990

Serous surface carcinoma of the peritoneum: a clinicopathologic study of 22 cases.

Serous surface carcinoma (SSC) of the peritoneum is defined as a primary tumor histologically indistinguishable from serous carcinoma of the ovary, diffusely involving the peritoneal surface but sparing or only superficially invading the ovaries. In this study of 22 cases of SSC, it was found that the main clinical manifestations of SSC were abdominal pain and enlargement. In most cases, SSC evenly involved the entire mesothelial surface but rarely was predominant in or even limited to the pelvis. It frequently invaded the submesothelium, but deep invasion into abdominal and pelvic organs or local metastasis was rare, and distant metastasis was not seen at presentation. Microscopically, SSC was a high-grade tumor frequently showing high mitotic rate, psammomas bodies, and necrosis. The tumor was usually contiguous with hyperplastic mesothelium on either ovarian surface or other locations. Tumor cells in all cases except one showed cytoplasmic or surface neutral or acidic mucin or both. Tumor cells stained positive for keratin (100% of cases), epithelial membrane antigen (100%), Leu-M1 (45%), B72.3 (85%), vimentin (35%), and carcinoembryonic antigen (25%). Electron microscopic studies of six cases showed epithelial differentiation in each. Seven patients (32%) were alive with no clinical disease at 3 to 31 months, one patient (4%) was alive with extensive local disease at 24 months, 11 patients (50%) died almost exclusively of local recurrence at 1 to 70 months, and three patients (14%) died of operative complications. It is concluded that SSC arises from peritoneal mesothelium but has epithelial phenotype. It can be morphologically differentiated from other conditions with similar laparotomy findings, such as malignant mesothelioma, benign papillary mesothelioma, cystic mesothelioma, and benign or borderline peritoneal serous tumors. The prognosis of SSC is poor, and most patients die of uncontrollable local disease.

Adult↗
PubMed1991

Primary clear cell carcinoma of the peritoneum.

A case of primary clear cell carcinoma of the pelvic and abdominal peritoneum which occurred in a 67-year-old woman and with histological characteristics of Mullerian derivation is presented. To our knowledge, this is the first report of such a case. Although clear cell carcinomas have been previously described in peritoneal or retroperitoneal locations, these have been mass lesions thought to arise from endometriosis. All other cases of diffuse primary peritoneal adenocarcinomas have been of the serous type.

Adenocarcinoma↗
PubMed1994

Effects of thymus supernatants on the phenotype of different subsets of peritoneum antigen-presenting cells.

Peritoneal cells (PC) obtained 2 h subsequent to intraperitoneal (i.p.) injection of low doses (200 micrograms) of a purified fraction of rat male accessory glands (FI-RAG) are phenotypically and functionally different from those obtained 24 h after i.p. injection. In fast, PC obtained 2 h after FI-RAG injection are mainly IE+ and are involved in inducing specific suppression to RAG. In contrast, PC obtained 24 h after FI-RAG injection are mainly IA+ and capable of inducing specific response to RAG. For their induction, IA+ PC require cells within or recently derived from bone marrow. In order to analyze the mechanisms involved in IA+ bone marrow-dependent cell generation in the peritoneum, we studied the distribution of FI-RAG following i.p. injection. It was established that FI-RAG is found mainly in the thymus 2 h after injection and remains there for at least 24 h. Subsequently, we analyzed, in 4 groups of rats, the influence of thymic culture supernatants on the phenotype of cells appearing in the peritoneal cavity 2 h after FI-RAG injection. An increase in IA+ PC was observed 2 h after i.p. injection of FI-RAG in animals that had received either supernatants from normal thymic cells cultured with FI-RAG or those from thymic cells taken from animals injected with FI-RAG 2 h prior to being killed. Supernatants of thymic cells from animals injected with FI-RAG 24 h prior to being killed or from normal thymic cells do not increase the percentage of IA+ PC.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2005

Laparoscopic staging in patients with incompletely staged cancers of the uterus, ovary, fallopian tube, and primary peritoneum: a Gynecologic Oncology Group (GOG) study.

OBJECTIVE: The purpose of this study was to determine the feasibility of laparoscopically staging patients with incompletely staged cancers of the uterus, ovary, fallopian tube, and primary peritoneum, and to evaluate related effects. STUDY DESIGN: Patients without evidence of metastatic disease had laparoscopic bilateral para-aortic and pelvic lymph node dissection. Other procedures were individualized based on extent of the primary surgery; laparotomy was undertaken for identified resectable disease. RESULTS: Ninety-five eligible patients were entered on 2 Gynecologic Oncology Group (GOG) protocols. Eleven were excluded. Fifty-eight patients (69%) underwent complete endoscopic staging with photographic documentation. Nine others (10%) were incompletely staged. Seventeen patients (20%) had laparotomy. In patients undergoing laparoscopy, 6% had bowel complications; 11% were found to have more advanced disease. Hospital stay was significantly shorter with laparoscopy alone (3 vs 6 days, P = .04). CONCLUSION: Interval laparoscopic staging of gynecologic malignancies can be successfully undertaken in selected patients, but laparotomy for adhesions or metastatic disease and risk of visceral injury may be anticipated.

Adult↗
PubMed2006

Three-dimensional power doppler ultrasound is useful to monitor the response to treatment in a patient with primary papillary serous carcinoma of the peritoneum.

To date, this is the first report to monitor changes of intratumor vascularization and the response to radiation and Cyberknife therapy in a patient with recurrent primary papillary serous carcinoma of the peritoneum by three dimensional (3D) power Doppler ultrasonography (PDUS). Transvaginal 3D PDUS detected a recurrent presacral tumor with abundant intratumor vascularity. Serial examinations of the tumor volume and serum CA-125 level were studied before, during, and 6 mo after therapy. Meanwhile, the intratumor blood flow was measured and expressed as vascularity indices. All of the tumor volume, intratumor vascularity indices and serum CA-125 level decreased progressively following therapy. A remaining lesion with nearly absent intratumor power Doppler signals suggested a scarring lesion posttreatment. Indeed, CT-guided tissue biopsy confirmed fibrotic change. 3D PDUS is useful to monitor the response to treatments and to differentiate residual tumors from lesions of scarring change posttreatment. It provides more accurate posttreatment information than pelvic computed tomography.

Aged↗
PubMed2004

Multicystic benign mesothelioma of the peritoneum presenting as postmenopausal bleeding and a solitary pelvic cyst--a case report.

BACKGROUND: All non-invasive diagnostic algorithms suffer from diagnostic uncertainty in discriminating benign from malignant adnexal masses. CASE: We present a case where the identification of a large solitary multiloculated pelvic cyst in a woman with postmenopausal bleeding was shown to be multifocal multicystic benign mesothelioma (MBM) of the peritoneum at laparotomy. CONCLUSION: We wish to alert gynaecologists of this rare association and the unique appearance of mesothelioma lesions, which many would not instantly recognise. There is a lack of consensus on the treatment and follow-up of MBM. Most authorities consider curative treatment of MBM is achievable through complete disease cytoreduction (peritonectomy) as carried out in the case.

Cysts↗
PubMed2004

Phase 2 trial of carboplatin plus tamoxifen in platinum-resistant ovarian cancer and primary carcinoma of the peritoneum.

OBJECTIVES: A previously reported phase 2 trial suggested substantial clinical activity associated with the combination of a platinum agent and tamoxifen in the treatment of platinum-resistant ovarian cancer. We wished to confirm or refute this observation in a patient population with well-characterized platinum-resistant disease. METHODS: Patients with ovarian or fallopian tube cancers or primary carcinoma of the peritoneum whose disease had either failed to respond to a platinum-based regimen or had responded but experienced a "treatment-free interval (TFI)" of < or =3 months, or if the TFI was >3 months they had been retreated and failed a platinum-based program, were eligible for entry into this phase 2 single institution protocol. Carboplatin (AUC 5) was delivered on a q-21 day cycle. Tamoxifen was administered at a dose of 80 mg/day for the first cycle, and then reduced to 40 mg/day. Treatment was to be continued until evidence of disease progression or unacceptable toxicity. RESULTS: Fourteen patients were treated on this phase 2 trial. In addition to being platinum-resistant, 10 patients had cancers that were also documented to be taxane-resistant (similar criteria to that defined above for platinum). While treatment was generally well tolerated, there were no objective (measurable disease or CA-125 response criteria) or subjective responses to this treatment program. CONCLUSION: In this phase 2 trial, we have been unable to confirm a meaningful level of clinical activity for the combination of carboplatin plus tamoxifen in a patient population with well-characterized platinum-resistant ovarian cancer.

Adult↗
PubMed2005

Primary malignant mesothelioma of the peritoneum: a clinical and immunohistochemical study.

BACKGROUND: Primary peritoneal mesothelioma is regarded as a fatal disease that presents with progressive ascites at a relatively late stage of its natural history. Differential diagnosis between this rare tumor and both serous papillary carcinoma of the peritoneum and ovary can be problematic. CASE: A 54-year-old woman presented to our institution with a 4-month history of dull epigastric pain and increased abdominal girth. Exploratory laparotomy revealed the presence of extensive intraperitoneal dissemination of a malignant neoplasm without a recognizable primary site. Suboptimal cytoreduction was carried out, and histological diagnosis was that of a malignant epithelioid mesothelioma. This was confirmed with a panel of immunohistochemical markers. The patient despite having a complete response after adjuvant chemotherapy died 18 months after primary surgery. CONCLUSION: No single immunohistochemical stain is pathognomonic of peritoneal primary malignant mesothelioma (PMM), and the results of a panel of antibodies should be interpreted to set the diagnosis.

Female↗
PubMed2006

Testing of two binary grading systems for FIGO stage III serous carcinoma of the ovary and peritoneum.

OBJECTIVE: A variety of histologic grading systems for ovarian carcinoma have been used, but there is no widely accepted system. Binary grading systems are inherently superior to the more common three-grade systems because they are more reproducible and they correspond to the number of options in the binary treatment decision for which grade is considered important: the use of or withholding of chemotherapy. METHODS: One hundred thirteen unselected FIGO stage III serous carcinomas of the ovary and peritoneum were tested with two grading systems: a binary system recently proposed by investigators at MD Anderson Cancer Center (MDACC) and a new binary system we formulated at the Washington Hospital Center (WHC). Both of these systems are based on nuclear grade. The WHC system has a higher threshold of nuclear size for diagnosing high-grade tumors. RESULTS: The WHC system separated the cases into 89 high-grade and 24 low-grade tumors. The median survival rates were 30 and 49 months for high and low grade respectively, and the actuarial survival curves were not significantly different (P > 0.10). The MDACC system separated the cases into 103 high-grade and 10 low-grade tumors. With this system, low-grade tumors were significantly more likely than high grade to be stage IIIA (P < 0.05) and occurred at a mean age of 57 years compared to 65 years for high-grade tumors (P < 0.05). Low-grade tumors were suboptimally debulked in 10% of cases compared to 27% for high-grade tumors (P > 0.05). The median survival for high-grade tumors was 34 months, and the median for low grade has not been reached. The actuarial survival curves were not significantly different (P = 0.065). CONCLUSION: The MDACC grading system appears more promising than the WHC system. The MDACC system separates a small (9% of advanced stage serous carcinomas) but distinctive well-differentiated tumor which usually has the appearance of invasive low-grade (micropapillary) serous carcinoma. The rarity of this tumor, however, will require a larger series to demonstrate prognostic value. The WHC system, which was designed to enlarge the low-grade group to a size that would be more meaningful in clinical practice, did not demonstrate a survival difference. The failure of the WHC system suggests that attempts to enlarge the low-grade group using histologic features alone are unlikely to be successful. The potential for confounding of grade with substage, volume of residual disease and patient age are issues that may impede determination of the independence of tumor grade in prognosis, and more data, especially for low-grade tumors, are needed.

Cystadenocarcinoma, Serous↗
PubMed2000

Identification of a novel 9 cM deletion unit on chromosome 6q23-24 in papillary serous carcinoma of the peritoneum.

To define regions of deletion on chromosome 6q in papillary serous carcinoma of the peritoneum (PSCP), we analyzed 103 tumor tissues from 53 patients by using 11 polymorphic microsatellite markers spanning loci from 6q23 to 6q27. Allelic losses on 6q were observed in 42 of 53 (79.2%) cases. We identified 3 distinct regions with a high percentage (>40%) of loss of heterozygosity. The first region is located at 6q23-24 and defined by D6S311 (15 of 35 informative cases, 42.9%). Detailed deletion mapping of chromosome 6q23-24 in these tumor samples identified a novel 9 cM minimal deletion region flanked by D6S250 and ESR. The second one is located at 6q25.1-25.2 and defined by D6S448 (17 of 36 informative cases, 47.2%). A second minimal deletion region of 4 cM was flanked by D6S420 and D6S442. The third region is located at 6q27 and defined by D6S297 (9 of 19 informative cases, 47.4%). Comparing these results with our cases of advanced staged invasive serous epithelial ovarian carcinoma (SEOC), we observed that allelic losses at D6S311 (6q23) and D6S149 (6q27) were significantly higher for PSCP than for SEOC. The pattern of allelic loss at each tumor site within an individual patient was also studied. A total of 36 cases displayed allelic loss for at least 1 of multiple tumor sites, and 35 of these patients exhibited nonidentical patterns of allelic loss at various tumor sites of the same patient. Furthermore, an alternating pattern of allelic loss in the same patient was identified in 3 of 53 patients studied. These results show that allelic losses on 6q are very frequent in PSCP, and we show 2 discrete minimal deletion regions on 6q, suggesting the existence of at least 2 tumor suppressor genes within 6q that may be involved in the pathogenesis of PSCP. In addition, the finding of different patterns of allelic loss at different tumor sites within the same patient indicate a mutifocal origin in some PSCP cases. These results provide strong evidence to support our previous reports that PSCP is a multifocal disease entity.

Chromosome Deletion↗