A 52-year-old woman presents with progressive abdominal distension over 8 months. Laparoscopy reveals abundant gelatinous material coating the peritoneum and omentum. Biopsy shows pools of acellular mucin containing strips of bland columnar epithelium without significant atypia. What is the most likely primary site?

• A Ovary
• B Stomach
• C Pancreas
• D Appendix ✓

Explanation

Current pathological consensus holds that most cases of pseudomyxoma peritonei arise from a low-grade mucinous neoplasm of the appendix, often with ovarian involvement representing secondary implantation rather than a synchronous primary. Gastric and pancreatic primaries can disseminate mucin but carry high-grade features and worse biology. Treatment of appendiceal origin disease is cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, which reflects how Indian and international examinations frame this entity.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.