Hx: abdominal distention
Answer: Pseudomyxoma Peritonei
-accumulation of mucinous ascites from mucin producing tumor.
This case is the classic mucinous appendiceal tumor s/p multiple debulking surgeries!
Source: mucinous tumor of appendix (#1), colon, stomach, pancreas, urachus, ovary Rupture -> mucin & neoplastic cells into the peritoneum -> diffuse peritoneal spread of malignancy and increasing abdominal distention
Pseudomyxoma Peritonei (Imaging)
US - echogenic peritoneal masses
CT - low/simple fluid locules w mass effect +/- ring calcs
->scalloping of organ surfaces and centrally displaced small bowel
MR - low T1, high T2 (follows water) +/- enhance
Pseudomyxoma Peritonei Complications:
- fibrosis + adhesions -> recurrent bowel obstructions (can be fatal)
Treatment: +surgical debulking +intraperitoneal chemotherapy