Primary peritoneal carcinoma presenting as adenocarcinoma on a Pap smear. A case report.
BACKGROUND
Primary peritoneal carcinoma is an uncommon malignancy that usually presents with gastrointestinal symptoms from abdominal carcinomatosis.


METHODS
A postmenopausal woman presented with vaginal bleeding and adenocarcinoma cells on a Pap smear. Colposcopy, endocervical and endometrial curettage, mammography, colonoscopy and pelvic ultrasound were all normal. Computed tomography revealed a large omental cake and ascites, and the CA-125 level was elevated, 2,907 IU/mL. Exploratory laparotomy revealed a primary peritoneal carcinoma with abdominal carcinomatosis.


CONCLUSIONS
Primary peritoneal carcinoma should be considered in the differential diagnosis of adenocarcinoma cells arising on a Pap smear in the absence of cervical and endometrial cancer.
Wright
Jason D
JD
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA. wrightj@msnotes.wustl.edu
Horowitz
Neil S
NS
Rader
Janet S
JS
D001201:Ascites / Q000209:etiology; D018394:CA-125 Antigen / Q000097:blood; D003127:Colposcopy; D018283:Cystadenocarcinoma, Papillary / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009852:Omentum; D065006:Papanicolaou Test; D010534:Peritoneal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017698:Postmenopause; D014057:Tomography, X-Ray Computed; D014592:Uterine Hemorrhage / Q000209:etiology; D014626:Vaginal Smears
D018394:CA-125 Antigen