Interventional radiology strategies in the treatment of pseudomyxoma peritonei.
OBJECTIVE
To describe percutaneous maneuvers to treat the unusual entity symptomatic pseudomyxoma peritonei (PMP).


METHODS
Four patients with PMP were treated by interventional radiology techniques that included large catheters (20-30 Fr) alone (n = 3), multiple catheters (n = 4), and dextran sulfate as a catalytic agent through smaller catheters (n = 1). The causes of the PMP were tumors in the ovary (2 patients), appendix (1 patient), and colon (1 patient). Each patient previously had undergone at least two operations to remove the PMP, and all patients had symptomatic recurrence. An in vitro analysis of catalytic agents also was performed.


RESULTS
All four patients improved symptomatically. Follow-up CT scans demonstrated marked reduction of PMP material in all cases. One patient underwent another interventional radiology session 5 months after the first; the other three patients had no recurrence of symptoms. One patient had reversible hypotension 2 hr after the procedure. The amount of material removed varied from 3 to 6 L.


CONCLUSIONS
These interventional radiology techniques were effective and safe for PMP and suggest options for this difficult medical and surgical problem.
vanSonnenberg
Eric
E
Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA. ericvansonnenberg@yahoo.com
Goodacre
Brian W
BW
Wittich
Gerhard R
GR
Ali
Seham
S
Silverman
Stuart G
SG
Shankar
Sridhar
S
Tuncali
Kemal
K
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D011553:Pseudomyxoma Peritonei / Q000000981:diagnostic imaging / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods*; D016896:Treatment Outcome