SHORT REPORT Pseudomyxoma peritonei: unusual origin from an ovarian mature cystic teratoma

Pseudomyxoma peritonei (PMP) is classified into pathologi-cally and prognostically distinct categories, such as dis-seminated peritoneal adenomucinosis (DPAM) and peritoneal mucinous carcinomatosis. There is overwhelming evidence that DPAM arises from a mucinous adenoma of the appendix. The one exception to this is the presentation of a mature ovarian cystic teratoma as PMP where the appendix is normal. This report describes such a case and discusses the presentation, histopathology, and treatment options. P seudomyxoma peritonei (PMP) is classified into patho-logically and prognostically distinct categories, such as disseminated peritoneal adenomucinosis (DPAM) and peritoneal mucinous carcinomatosis. There is overwhelming evidence that DPAM arises from a mucinous adenoma of the appendix. The one exception to this is the presentation of a mature ovarian cystic teratoma as PMP where the appendix is normal. We report such a case and discuss the presentation, histopathology, and treatment options. CASE REPORT A 39 year old woman presented with a three month history of abdominal distension and an episode of abnormal per vaginal bleeding. Clinical examination revealed a mass arising out of the pelvis and ultrasound examination demonstrated a large multicystic complex mass containing fluid and solid compo-nents, arising from the left ovary. The tumour marker CA125 was normal at 11 KU/litre. At laparotomy, copious amounts of free mucin and tenacious mucinous deposits were seen on the surface of the omentum and bowel. There was a 106 12 cm left ovarian mass and a small right ovarian cyst. Peritoneal lavage, hysterectomy, bilateral salpingo-oophor-ectomy, omentectomy, and appendicectomy were performed. After an uneventful recovery she was referred to our PMP centre for further management. Nine months after surgery, an abdominal computed tomography scan shows no evidence of PMP and tumour markers such as carcinoembryonic antigen, CA125, and CA19-9 are within normal limits