大腸ポリープ癌より発生した腹膜偽粘液腫の1例

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  • A CASE REPORT OF PSEUDOMYXOMA PERITONEI DERIVED FROM POLYPOID COLON CANCER

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A 61-year-old man was admitted to our hospital for further evaluation of an abdominal tumor. Abdominal ultrasonography, CT, and MRI demonstrated the presence of a large mass with ascitic septations in the peritoneal cavity, although the origin of the mass was not apparent. Percutaneous tumor biopsy revealed gelatinous fluid with adenocarcinomatous cells. Colonoscopy revealed a large pedunculated polyp in th transverse colon, and endoscopic biopsy specimens from this polyp were shown to be tubular adenoma histologically. It was suspected that the abdominal tumor might be a pseudomyxoma peritonea then resection of the tumor and partial colectomy involving the segment with the polyp was performed. At laparotomy, there was a large tumor in the peritoneal cavity with massive mucinous material, the tumor appeared to originate from the pedunculated polyp of 40 mm in siqe in the tranxverse colon. The appendix was normal. Pathologically, the final diagnosis was a pseudomyxoma peritonea originating from the mucinous adenocarcinoma, identified as the pedunculated polyp. Recent work has shown that pseudomyxoma peritonei occurs secondary to malignant mucosecreting tumors, mainly origination from the appendix or ovary. According to the literature, this is a rare case of pseudomyxoma peritonei originating from mucinous adenocarcinoma of the colon presenting as a pedunculated polyp.

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