Department of Obstetrics and Gynecology, Fukushima Red Cross Hospital.
Department of Surgery, Fukushima Red Cross Hospital.
Fukushima J Med Sci. 2023 Apr 5;69(1):57-65. doi: 10.5387/fms.2022-41. Epub 2023 Mar 30.
We describe four cases of pseudomyxoma peritonei (PMP) that were diagnosed and treated at our hospital.Case 1: A 26-year-old woman with a large multicystic ovarian tumor and massive ascites was diagnosed with PMP originating from a borderline mucinous ovarian tumor. She underwent fertility-preserving staging laparotomy and was treated with three courses of intraperitoneal chemotherapy. There has been no recurrence in the 15 years since her first operation. Case 2: A 72-year-old woman with a giant ovarian tumor and massive ascites was diagnosed with PMP originating from low-grade appendiceal mucinous neoplasm (LAMN). After laparotomy, the patient was managed conservatively because she did not want aggressive treatment. She has remained asymptomatic with a small amount of ascites for 3 years. Case 3: A 82-year-old woman with ovarian tumors, massive ascites, and suspected PMP underwent emergency laparotomy due to appendiceal perforation and pan-peritonitis. She was diagnosed with PMP originating from LAMN. She has remained asymptomatic with a small amount of ascites for 2 years. Case 4: A 42-year-old woman with multicystic ovarian tumors and massive ascites underwent laparotomy. She was diagnosed with PMP originating from LAMN. Since multidisciplinary treatment was indicated and desired, the patient was referred to a specialized facility where cytoreductive surgery and hyperthermic intraperitoneal chemotherapy was performed. The patient has done well since the treatment.Although most cases of PMP originate from mucinous tumors of the appendix, female patients with PMP often present with ovarian tumors and are commonly referred to gynecology clinics. It is therefore important for gynecologists to be familiar with PMP and to be able to diagnose it accurately and select the most suitable management including multidisciplinary treatments.
我们描述了在我院诊断和治疗的 4 例腹膜假性黏液瘤（PMP）病例。
病例 1：一位 26 岁女性，因巨大多囊卵巢肿瘤和大量腹水就诊，诊断为来源于交界性黏液性卵巢肿瘤的 PMP。她接受了保留生育力的分期腹腔镜手术，并接受了 3 个疗程的腹腔内化疗。自首次手术后 15 年来，她一直没有复发。
病例 2：一位 72 岁女性，因巨大卵巢肿瘤和大量腹水就诊，诊断为来源于低级别阑尾黏液性肿瘤（LAMN）的 PMP。剖腹手术后，由于患者不希望接受积极治疗，因此选择保守治疗。3 年来，她一直无症状，仅有少量腹水。
病例 3：一位 82 岁女性，因卵巢肿瘤、大量腹水和疑似 PMP 行急诊剖腹手术，因阑尾穿孔和全腹膜炎。她被诊断为来源于 LAMN 的 PMP。2 年来，她一直无症状，仅有少量腹水。
病例 4：一位 42 岁女性，因多囊卵巢肿瘤和大量腹水行剖腹手术。她被诊断为来源于 LAMN 的 PMP。由于需要并希望进行多学科治疗，患者被转诊至专门机构，接受了减瘤手术和腹腔内热化疗。自治疗以来，患者情况良好。
尽管大多数 PMP 病例起源于阑尾黏液性肿瘤，但女性 PMP 患者常表现为卵巢肿瘤，常被转诊至妇科诊所。因此，妇科医生熟悉 PMP 并能够准确诊断并选择最合适的管理方法（包括多学科治疗）非常重要。
