1.Clinical and ultrasound features of pseudomyxoma peritonei and its histopathological subtypes among women seen at a Philippine tertiary hospital: A 10‑year review
Toni Andrea Marie D. Viloria ; Melissa D. Amosco
Philippine Journal of Obstetrics and Gynecology 2023;47(5):239-248
Objectives:
Pseudomyxoma peritonei (PMP) in women arises from an appendiceal or ovarian
pathology and presents either of two histological subtypes of differing prognosis, disseminated
peritoneal adenomucinosis (DPAM), or peritoneal mucinous carcinomatosis (PMCA). This study
aimed to evaluate the demographic, clinical, and sonographic features among affected women and
the differences between the two histological subtypes.
Methods:
A retrospective study was conducted involving 36 women with histopathological diagnosis
of PMP who had preoperative ultrasound and underwent surgery at the department of obstetrics
and gynecology in a tertiary hospital. Demographic and clinical data, ultrasound images and reports,
and final histopathology were reviewed. To compare the subtypes, one‑way analysis of variance
for continuous data and Chi‑square/Fisher exact test for categorical data were used, with P < 0.05
indicating statistical significance.
Results:
Patients were mostly >50 years of age, multigravid, and presented with abdominal
distention. Ultrasound examinations consistently showed amorphous, mixed echo or echogenic
ascites, peritoneal thickening, and omental caking. Adnexal/ovarian masses were detected in
66.7% of cases. Omental caking was significantly more prevalent in PMCA (83.3%; P = 0.0002),
whereas larger ovarian tumors (>20 cm) and papillarities were more common in DPAM (both 92.9%;
P = 0.0005). Most patients underwent gynecologic surgery (n = 31; 86.1%), and 14 (38.9%) required
readmission due to recurrence. The final histopathology revealed largest tumor involvement of the
appendix (n = 13; 36.1%), the ovaries (n = 11; 30.5%), or undetermined (n = 12; 33.3%).
Conclusions
Preoperative diagnosis of PMP is possible based on its clinical and ultrasound
features. Although the subtypes are similar in most of these features, certain ultrasound findings
may aid in distinguishing them.
Pseudomyxoma Peritonei