Radiology Resident Case of the Week
Etiology/Pathophysiology
Pseudomyxoma peritonei is a relatively rare disease which generally results from rupture of a mucinous cystadenocarcinoma of either the ovary or appendix. Less frequently it can result from rupture and intraperitoneal spread of a tumor of the urachus, uterus or omphalomesenteric duct. Multiple gelatinous masses then form within the abdominal cavity with subsequent abdominal distension.
Pathology:
Miscellaneous
Imaging
CT abdominal imaging shows multiple low-attenuation masses within the peritoneal cavity which may have discrete walls or septations. They often cause scalloping of the liver margin secondary to extrinsic pressure. There can be calcifications within the walls or septae of these gelatinous masses. The appearance may be similar to that of loculated ascites, but scalloping of the liver border and failure of the bowel to float up toward the anterior abdominal wall may be useful in differentiating these two entities.
DDX
Psuedomyxoma peritonei, Loculated ascites.
Key references
Lee JK, Sagel SS, Stanley RJ. Computed Body Tomography, 1989, Raven Press, New York, 1989:698.
Moss AA, Gamsu G, Genant HK. Computed Tomography of the Body with Magnetic Resonance Imaging, 2nd ed. W B Saunders Company, Philadelphia, 1992:1148.
ACR Code
791.3196
Keywords:
pseudomyxoma peritonei