Pseudomyxoma Peritonei Accompanied by Intraductal Papillary Mucinous Neoplasm of the Pancreas

Vol. 5, No. 4-5, 2005

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Case Report

Pseudomyxoma Peritonei Accompanied by Intraductal Papillary Mucinous Neoplasm of the Pancreas
Yohei Mizuta^a, Yuko Akazawa^a, Ken Shiozawa^a, Hiroshi Ohara^a, Kazuo Ohba^a, Ken Ohnita^a, Hajime Isomoto^a, Fuminao Takeshima^a, Katsuhisa Omagari^a, Kenji Tanaka^b, Tohru Yasutake^b, Tohru Nakagoe^b, Kenji Shirono^c, Shigeru Kohno^a

^aSecond Department of Internal Medicine, and
^bFirst Department of Surgery, Nagasaki University School of Medicine,
^cDepartment of Internal Medicine, Shimabara Hospital, Nagasaki, Japan

Address of Corresponding Author

Pancreatology 2005;5:470-474 (DOI: 10.1159/000086551)

Key Words

Intraductal papillary mucinous neoplasm
Intraperitoneal hyperthermic chemoperfusion
Pseudomyxoma peritonei

Abstract

We describe a case ofpseudomyxoma peritonei (PMP) successfully managed with intraperitoneal hyperthermic chemoperfusion. This case is unique due to the concurrent presence of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. The patient presented with abdominal fullness. Abdominal computed tomography revealed massive ascites, thickened peritoneum, and a cystic lesion of the pancreas. Cytological examination of ascitic fluid sample showed mucin-rich atypical cells. Endoscopic retrograde pancreatography revealed a cystic lesion with the defect probably due to mural nodule and mucin, communicating with the pancreatic duct. At exploratory laparotomy, massive ascites and multiple nodules were identified within the peritoneal cavity. No primary tumour, including mucinous neoplasm of the appendix, was found. Histopathological examination of the omentum showed mucinous adenocarcinoma in pools of mucoid material, consistent with PMP. The relation between PMP and IPMN of the pancreas was possible, but not conclusive. The patient received intraperitoneal perfusion of saline heated to 42°C containing cisplatin, etoposide, and mitomycin C, followed by 24 courses of postoperative chemotherapy with gemcitabine. The patient remains in good general condition with no signs of progression of PMP for 2 years, but with a gradual and progressive enlargement of the pancreatic cystic lesion.

Author Contacts

Yohei Mizuta, MD
Second Department of Internal Medicine
Nagasaki University School of Medicine
1-7-1, Sakamoto, Nagasaki 852-8501 (Japan)
Tel. +81 95 849 7273, Fax +81 95 849 7285, E-Mail ymizuta@net.nagasaki-u.ac.jp

Article Information

Published online: June 27, 2005
Number of Print Pages : 5
Number of Figures : 4, Number of Tables : 1, Number of References : 19

Medline Abstract (ID 15983445)

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