title: Enormous cystic tumor of peritoneal psammocarcinoma exhibiting complete response to Cisplatin and cyclophosphamide after suboptimal cytoreduction: case report and review of the literature.
abstract: Psammocarcinoma is a serous peritoneal tumor arising from the ovary or the peritoneum and characterized by low-grade nuclear features, extensive psammoma bodies, and invasiveness. Only 62 cases have ever been documented, 30 primary peritoneal and 32 primary ovarian, most of which presented as small tumors. Adjuvant therapies, including chemotherapy and radiation, were performed in 12 of the primary peritoneal cases, without any clear evidence of benefit. We present a case of an unusually large primary peritoneal psammocarcinoma with unexpected outcome. The patient was a 38-year-old woman with a tumor of the peritoneum which adhered densely to the uterus and rectum and developed into the intra-abdominal cavity and retroperitoneal space. After adhesiolysis of the tumor and rectum, suboptimal surgical reduction left a 4 cm × 2 cm tumor segment. Postoperative chemotherapy, consisting of paclitaxel and carboplatin (TC) for 1 course, and cyclophosphamide and cisplatin (CP) for 5 courses, was conducted. The residual tumor responded completely to the chemotherapy and the patient is alive today, with no evidence of disease 15 months after the surgery. Our case implies that CP therapy is a potential regimen of postoperative remission-induction therapy for suboptimally resected primary peritoneal psammocarcinoma.
authors.affiliation: Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital, Toyonaka, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Takahashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ueda
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Shioji
authors.forename: Shiro
authors.initials: S
authors.lastname: Adachi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohashi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Morii
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Aozasa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Masami
authors.initials: M
authors.lastname: Fujita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tokuhira
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage*; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003520:Cyclophosphamide; D002945:Cisplatin