No abstract available.
Peritoneum*

Multicystic benign mesothelioma (MBM) of the peritoneum is a very rare condition. Since the first description of MBM in 1979, approximately 100 cases have been reported. This is a case report of MBM of the pelvic peritoneum presenting as acute abdominal pain in a young woman. Laparoscopy confirmed multiple grapelike clusters of cysts that originated in the peritoneum of the rectouterine pouch and histopathologic diagnosis was confirmed as MBM of the pelvic peritoneum. We hope to alert gynaecologists of the diagnostic and therapeutic approaches to MBM which can be accomplished by laparoscopy.
Abdominal Pain ; Douglas' Pouch ; Female ; Humans ; Laparoscopy ; Mesothelioma ; Peritoneum

PURPOSE: To determine usefulness of spiral CT in the preoperative evaluation of peritoneal seeding from a gastric carcinoma. MATERIALS AND METHODS: From a database of 411 consecutive patients with surgically proven advanced gastric cancinoma obtained over a six-month period, 17 with peritoneal seeding and a control group of 24 without peritoneal seeding underwent spiral CT scanning with 7 -8 mm scan thickness and interval during the portal phase. Preoperative CT images were analyzed by two readers who reached a consensus with regard to the presence and location of the ascites, thickening of the parietal peritoneum, and changes in the omentum and mesentery. RESULTS: Ascites was present in 47% (8/17) of patients with peritoneal seeding The right subhepatic space (n=6, 35%) and right paracolic gutter (n=5, 29%) but not the cul-de-sac (n=2, 12%)-were common sites of fluid collection. Permeative changes in the omentum and mesentery were seen in 18% (3/17) and 12% (2/17) of patients, respectively. Among five controls with false positive results, ascites in the cul-de-sac was present in three (two males and one female, 12%) while omental nodules and a thickened peritoneum were found in two (8%) and one (4%), respectively. In nine controls with false negative results, small disseminated nodules were seen in the mesentery and omentum at surgical field. The sensitivity and specificity of spiral CT were 47% (8/17) and 79% (19/24), respectively. CONCLUSION: In terms of sensitivity and specificity, spiral CT is not especially accurate in distinguishing peritoneal seeding from gastric carcinoma.
Ascites ; Consensus ; Female ; Humans ; Male ; Mesentery ; Omentum ; Peritoneum ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, Spiral Computed*

PURPOSE: Micrometastasis is known as a significant predictor of prognosis in colorectal cancer patients. Recently, reverse transcriptase polymerase chain reaction (RT-PCR) has been applied to detecting micrometastasis. The drainage vein and peritoneum were examined and the micrometastases assessed in a series of colorectal cancer patients. METHODS: 22 patients, who were histologically diagnosed with colorectal cancer, and 8 patients of serosal and peritoneal brushing, were examined using RT-PCR to amplify the mRNAs for two epithelial markers, carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20). RESULTS: Among the 22 colorectal cancer patients, the positive rates of CK-20 and CEA mRNAs in the drainage vein were 10 (45%) and 7 (32%), and those of the serosal and peritoneal brushing were 6 (75%) and 5 (63%), respectively. CONCLUSION: These results suggest that the "no touch isolation technique" might be useful for operations in advanced colorectal cancer patients, and the brushing of the serosal or Douglas pouch can represent the micrometastasis status.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Douglas' Pouch ; Drainage ; Humans ; Keratin-20* ; Keratins* ; Neoplasm Micrometastasis* ; Peritoneal Cavity* ; Peritoneum ; Prognosis ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Veins*

Malignant deciduoid mesothelioma is a rare malignant neoplasm occurring in the peritoneum of young women. We report a case of malignant deciduoid mesothelioma that occurred in the omentum of a 47-year-old woman. The patient had never exposed to asbestos and had no history of cesarean section. The lesions were multiple infiltrative nodules affected the peritoneal cavity, omentum, and surface of the uterus with both ovaries. Microscopically, the nodules were composed of mesothelial cells similar to decidual cells
Asbestos ; Cesarean Section ; Female ; Humans ; Mesothelioma* ; Middle Aged ; Omentum ; Ovary ; Peritoneal Cavity ; Peritoneum ; Pregnancy ; Uterus

Splenosis is the autotransplantation of fragmented splenic tissue that occurs as a result of traumatic splenic rupture or a routine splenectomy. Generally, splenic implants are numerous and located within the peritoneal cavity; peritoneum, omentum and abdominal viscera, and occasionally on extra-abdominal surfaces. Splenic implants are rarely clinically significant and are incidental found during an abdominal operation, but occasionally mimics primary or metastatic tumors, as seen on radiological studies. Herein, the case of a patient in whom multiple abdominal masses were identified as splenosis, but the initial radiographic finding was that of carcinomatosis peritonei.
Autografts ; Carcinoma* ; Humans ; Omentum ; Peritoneal Cavity ; Peritoneum ; Splenectomy ; Splenic Rupture ; Splenosis* ; Stomach Neoplasms* ; Viscera

Primary omental tumors are rare, with most being metastatic, especially those from intra-abdominal organs. Breast and lung malignancies, as well as melanomas, are frequent causes of extra-abdominal cancers metastasizing to the omentum, peritoneum and mesentery. The case of a metastatic omental melanoma from the choroid of the eye was experienced, which formed a solitary mass in the omentum similar to that of a primary omental tumor. The patient was unaware of the nature of her eye disease following enucleation seven years previously. Concomitant liver metastases were also not identified on a CT scan, due to their relatively small sizes. Therefore, the metastatic melanoma was misconceived as a primary omental tumor until laparotomy and pathologic confirmation. This case shows that a metastatic melanoma can be presented as an abdominal mass, and should be considered in the differential diagnosis of an intra-abdominal mass.
Breast ; Choroid* ; Diagnosis, Differential ; Eye Diseases ; Humans ; Laparotomy ; Liver ; Lung ; Melanoma* ; Mesentery ; Neoplasm Metastasis ; Omentum ; Peritoneum ; Tomography, X-Ray Computed

PURPOSE: Hepatoid adenocarcinoma of the stomach is a variant of gastric carcinoma with both adenocarcinoma and hepatocellular carcinomatous differentiations. Until recently, few reports had been published. The purpose of this study was to evaluate the radiologic characteristics of eleven hepatoid adenocarcinomas of the stomach aswell as patterns of metastasis. MATERIALS AND METHODS: Eleven pathologically proven cases of hepatoidadeno carcinoma of the stomach were retrospectively reviewed. Radiologic studies available were CT in eight patients, abdominal ultrasonography in ten, upper GI series in seven, and hepatic angiography in two. Pathologicand radiologic characteristics of these lesions, patterns of metastasis, if present, and labolatory data(AFP andCEA) were evaluated. RESULTS: Tumors were seen in the antrum and body in five patients, in the antrum in five, and in the body of the stomach in one. Six tumors were classified as Borrmann type 3, four as Borrmann type 2, andone as Borrmann type 4. Nine cases showed hepatic metastasis. Portal vein thrombosis was present in three cases ;two were accompanied by multiple liver metastasis and the other had portal venous thrombosis. Lymph nodemetastasis was identified in 11 cases ; N1 in five, N2 in five, and extensive retroperitoneal paraaortic and left supraclavicular lymphadenopathy in one. Angiography showed hypervascular metastatic liver masses in two cases.There was no evidence of metastasis to the mesentery, omentum, and peritoneum. Serum AFP was elevated in tencases(mean : 24752.2 ; median : 4230 ng/ml). CONCLUSION: Radiologic findings of hepatoid adenocarcinoma of thestomach appear similar to those of non-hepatoid adenocarcinoma. However, elevation of AFP and early liver metastasis without peritoneal metastasis is suggestive of hepatoid adenocarcinoma of the stomach.
Adenocarcinoma* ; Angiography ; Humans ; Liver ; Lymphatic Diseases ; Mesentery ; Neoplasm Metastasis ; Omentum ; Peritoneum ; Retrospective Studies ; Stomach* ; Ultrasonography ; Venous Thrombosis

PURPOSE: Abdominal CT scans in patients with intraperitoneal fluid were retrospectively studied to identify characteristic features useful for differential diagnosis of various causes. MATERIALS AND METHODS: One hundred and seventy patients with intraperitoneal fluid collection were classified as categories of hepatic disease, carcinomatosis, and infectious disease. We analyzed sites of fluid collection, the presence of peritoneal thickening, omental and mesenteric fat infiltration, and lymph node enlargment. RESULTS: Intraperitoneal fluid was present in subhepatic space, subphrenic space, paracolic gutter, mesentery, and fossa of the gallbladder in decreasing order of frequency. Fluid in the gallbladder fossa was the most frequent in hepatic diseases. The fluid collection in subhepatic and subphrenic space was less frequent in infectious diseases. Peritoneal thickening was noted in infectious diseases, and carcinomatosis. Omental fat infiltration and enlarged lymph nodes were the most frequent in carcinomatosis (58% and 44%, respectively), whereas, mesenteric fat infiltration and enlarged lymph nodes were the most common in infectious diseases (61%, and 26%, respectively). CONCLUSION: The location of peritoneal fluid collection showed some lesion specific characteristics, and CT features of fat infiltration and enlarged lymph nodes of peritoneum, omentum, and mesentery were helpful for differential diagnosis between carcinomatosis and infectious diseases.
Ascitic Fluid ; Carcinoma ; Communicable Diseases ; Diagnosis, Differential ; Gallbladder ; Humans ; Lymph Nodes ; Mesentery ; Omentum ; Peritoneum ; Retrospective Studies ; Tomography, X-Ray Computed

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.
Douglas' Pouch ; Endometriosis* ; Female ; Lymph Nodes ; Metaplasia ; Neoplasm Metastasis ; Ovary ; Peritoneum ; Stem Cells ; Teratoma*