Pseudomyxoma Peritonei Originated from Colon Cancer: Reports of Two Cases

Kim, Kyung Rae; Min, Byung Wook; Um, Jun Won; Moon, Hong Young

Abstract

Pseudomyxoma peritonei in which gelatinoid material deposits onto the peritoneum, accompanied by large amounts of mucinous ascites is a relatively infrequent disease, occurring with a 2 to 3-fold incidence in females. Among diverse benign and malignant tumors causing this condition, appendiceal and ovarian tumors are proved to be the most common. Yet on debate is whether these two tumors are simultaneously primary, while recent studies endorse the theory that the latter is secondary to the former. Removal of every inspected lesion should be performed in the treatment of pseudomyxoma peritonei. Laser photodynamic therapy after surgery is offered but still needs more clinical studies before utilization. Intraperitoneal or intravenous chemotherapy as intra- or postoperative adjuvant therapy is actively being studied for improvement of survival. The modality for treatment spotlighted recently is heated intraoperative intraperitoneal chemotherapy, based on the fact that chemoagents are more cytotoxic at a higher temperature of about 44 degrees C than at the usual body temperature and that pseudomyxoma peritonei rarely metastasizes via blood or lymph circulations. Many different clinical studies report many different results as to recurrence and survival rates. Tendency is that patients with pseudomyxoma peritonei which has originated from highly malignant tumors yield higher rate of operative complications and disease recurrence, and low survival rate on the other hand, which warrants ample studies and proper determination before any surgical procedure. We report with reviews of relavant literature two cases of pseudomyxoma peritonei we have experienced.