Philippine Journal of Surgical Specialties Vol. 66, No. 3, July-September 2011, pp 112-117

Peritonectomy in the Management of Pseudomyxoma peritonei Arising from Ovarian Mucinous Tumors – A Case Series

Author(s): Helen R. Amorin, M.D., F.P.O.G.S. and Jericho Thaddeus P. Luna, M.D., F.P.O.G.S.

Pseudomyxoma peritonei (PMP) is a rare condition that is more commonly seen in females and is characterized by the development of massive amounts of mucinous ascites. It is believed to originate mostly from mucocoeles of the appendix. However, other mucin-producing tumors in other organs such as the ovary have been implicated in its etiology. Due to the rarity of this condition, there have been no formal trials to provide guidelines for optimum treatment.

To determine the efficacy and safety of peritonectomy procedures in the treatment of patients with pseudomyxoma peritonei.

A retrospective review of patients diagnosed with pseudomyxoma peritonei was done. Demographic data and clinical outcomes of patients who underwent peritonectomy procedures were compared to those who did not undergo peritonectomy. Descriptive analysis of the data collected using frequency and percentages was used.

There were a total of 14 patients with pseudomyxoma peritonei from 2006-2009. Of the 11 patients with disseminated peritoneal adenomucinosis (DPAM), 4 patients (43%) underwent peritonectomy while the remaining 7 (67%) did not undergo the said procedure. All 4 patients with DPAM and the patient with benign ovarian mucinous tumor with PMP not otherwise specified as to whether DPAM or peritoneal mucinous carcinomatosis (PMCA) who underwent peritonectomy are currently alive with no evidence of disease. Survival in this group of patients ranged from 18-48 months, with a median survival of 29 months. There were no recurrences noted in this group of patients. Seven patients with DPAM did not undergo peritonectomy: 2 developed recurrent disease, 4 became lost to follow-up, while 1 continue to have no evidence of disease. Recurrences were noted between 13-29 months from the time of diagnosis of PMP. There were 2 cases of PMCA, both arising from malignant ovarian neoplasms. One died 5 months after surgery (without peritonectomy) while the other one who was treated with peritonectomy was lost to follow-up.

Peritonectomy is a safe treatment modality for pseudomyxoma peritonei arising from mucinous ovarian new growth

Key words: pseudomyxoma peritonei, peritonectomy