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Dr. Milica Glusac

Dr. Milica Glusac

General Hospital Niksic Montenegro, Serbia

Title: A RARE CASE PSEUDOMYXOMA PERITONEI AND FEMALE PELVIC MASS

Biography

Biography: Dr. Milica Glusac

Abstract

Pseudomyxoma peritonei  is a rare clinical entity with estimated incidence  of one to two per  million per year. It is characterized by diffuse intraabdominal gelatinous collections with mucinous implants on peritoneal surfaces and the omentum. PMP predominantly originates in the appendix in men, and synchronous ovarian and appendiceal   disease in women.

We presented a rare case of PMP caused by primary mucinous adenocarcinoma of the appendix who spread to the right ovary in the 48-years female.

She complained to   abdominal distension, abdominal pain in lower right quadrant and appearance umbilical hernia about two months duration. Expression levels of the tumor markers CA 125, CEA and   CA 19-9 were elevated but HE 4 was in normal range.

She underwent gynecologic  ultrasound, computed tomography scan and MRI  which   showed   multiseptated  cystic mass  in her  right lower quadrant  and a large amount of ascites in all abdominal recess uses.

The presumed preoperative diagnosis was Ca ovarii with dissemination lesions into liver, splenic and peritonea.  She underwent to exploratory laparoscopy.

 Approximately 5000 ml of gelatinous fluid was aspirated from the pelvis and abdomen. The right adnexectomy  and biopsio peritonei  was done .

Surgical specimens were submitted for immunohistochemical examinations to distinguish the origin of the tumor and finally it showed low grade mucinous adenocarcinoma  appendix.

In conclusion diagnosis of the adenocarcinoma appendix   is difficult due to its lack of specific symptoms and signs. Adenocarcinoma appendix is an extremely rare disease in clinical practice. Until 2002, less than 250 cases had been reported in literature.