title: Primary peritoneal carcinoma presenting on routine papanicolaou smear.
abstract: BACKGROUND
  Primary peritoneal carcinoma is an uncommon disease, characterized by peritoneal carcinomatosis without other identifiable primary tumor. It typically presents resembling ovarian cancer, with abdominal pain and distention and in an advanced stage. We report a unique presentation of this disease.
  
  
  METHODS
  A 76-year-old woman had severe glandular dysplasia on a screening Papanicolaou smear. An ectocervical lesion was biopsied, revealing moderately differentiated adenocarcinoma. Cervical stenosis prevented sampling of the endocervix and endometrium. Colonoscopy and mammography did not reveal malignancy. Total abdominal hysterectomy with bilateral salpingo-oophrectomy was performed. Surgery revealed surface implants on the pelvic organs, with minimal involvement of the ovaries. Histologic examination revealed adenocarcinoma with papillary serous differentiation. Surgical and microscopic findings were consistent with a diagnosis of primary peritoneal carcinoma.
  
  
  CONCLUSIONS
  Primary peritoneal carcinoma usually presents in a manner similar to that of ovarian cancer, but atypical presentations also occur. While a Papanicolaou smear suggestive of carcinoma usually represents a primary cervical malignancy, this case serves as a reminder that other metastatic malignancies should be considered.
authors.affiliation: David Grant Medical Center, Travis Air Force Base, CA 94535, USA. Tandy.Olsen@hotmail.com
authors.forename: T G
authors.initials: TG
authors.lastname: Olsen
authors.forename: L R
authors.initials: LR
authors.lastname: Nycum
authors.forename: R L
authors.initials: RL
authors.lastname: Graham
authors.forename: T
authors.initials: T
authors.lastname: Alagoz
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology*; D065006:Papanicolaou Test; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears