Peritoneum

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The peritoneum is a much neglected area, with relatively little pathology. It includes the omentum which is dealt with in the omentum article.

Benign

Peritoneal implants

  • These are dealt with in the ovarian tumours article. Broadly speaking they may be: (1) desmoplastic non-invasive, (2) epithelial non-invasive, and (3) invasive.

Well-differentiated papillary mesothelioma

Should not be confused with malignant mesothelioma or benign multicystic mesothelioma.
  • AKA benign papillary mesothelioma.

Peritoneal inclusion cyst

Malignant

Primary peritoneal serous carcinoma

General

  • Very rare.
  • Reported in men.[2]

Microscopic

Features:

  • Like serous carcinoma elsewhere - see ovarian serous carcinoma.
  • To exclude ovarian serous carcinoma all of the following criteria must be met:[3]
    1. Histology of the tumour = serous carcinoma.
    2. Bulk of the tumour involves the peritoneum.
    3. Ovarian substance tumour extent less than 5 x 5 mm in plane of section.
    4. Previous ovarian serous carcinoma is excluded.
      • Old oopherectomies reviewed if possible.

DDx:

IHC

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Should have comment something like:

High-grade serous carcinoma of the ovary/fallopian tube/periteonum is associated 
with BRCA1/2 mutation in approximately 20% of patients. Referral to genetic 
counseling is recommended.

Malignant mesothelioma

This is like the tumour found in the pleural cavity.

Peritoneal metastasis

  • AKA metastatic peritoneal disease.

General

Common causes:

Note:

Microscopic

See metastasis.

See also

References

  1. Vallerie, AM.; Lerner, JP.; Wright, JD.; Baxi, LV. (May 2009). "Peritoneal inclusion cysts: a review.". Obstet Gynecol Surv 64 (5): 321-34. doi:10.1097/OGX.0b013e31819f93d4. PMID 19386139.
  2. Shmueli, E.; Leider-Trejo, L.; Schwartz, I.; Aderka, D.; Inbar, M. (Apr 2001). "Primary papillary serous carcinoma of the peritoneum in a man.". Ann Oncol 12 (4): 563-7. PMID 11398893.
  3. Roh, SY.; Hong, SH.; Ko, YH.; Kim, TH.; Lee, MA.; Shim, BY.; Byun, JH.; Woo, IS. et al. (Jun 2007). "Clinical characteristics of primary peritoneal carcinoma.". Cancer Res Treat 39 (2): 65-8. doi:10.4143/crt.2007.39.2.65. PMC 273931. PMID 19746214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC273931/.
  4. Elias, D.; Rougier, P.; Mankarios, H.; Fahrat, F.; Lasser, P. (Mar 1993). "[Resectable liver metastases and synchronous extra-hepatic sites of colorectal origin. Surgical indications].". Presse Med 22 (11): 515-20. PMID 8511077.