Disseminated peritoneal adenomucinosis associated with a panperitonitis-like onset: report of a case.
A 59-year-old man was admitted to our department due to a fever of unknown origin. Abdominal ultrasonography and computed tomography showed a large cystic mass in the lower abdomen and a massive amount of abdominal fluid. A laparotomy was performed under a diagnosis of panperitonitis. Diffuse pyogenic gelatinous ascites and a large cystic mass with a grayish wall, and a hard solid lesion in part were found. The microscopic findings of the hard solid lesion showed calcification, osteogenesis, and focal epithelial proliferation in a tiny area consisting of mucinous cells with no significant cytologic atypia. The remaining part of the cystic wall and small cystic lesions were hyalinized, fibrous, or necrotic tissue. Since a total resection of the masses was not possible, the patient received adjuvant chemotherapy with cisplatin followed by the administration of mitomycin C and 5-fluorouracil. An abdominal fistula with the excretion of pyogenic gelatinous fluid occurred, but the patient is still alive and doing well over 2 years postoperatively. The primary site of this tumor could unfortunately not be identified.
Kuroki
Y
Y
Department of Surgery, Kamioka Town Hospital, Gifu, Japan.
Otagiri
S
S
Tsukada
K
K
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001201:Ascites / Q000209:etiology; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D010538:Peritonitis / Q000209:etiology*; D011553:Pseudomyxoma Peritonei / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
D016685:Mitomycin; D002945:Cisplatin; D005472:Fluorouracil