A 48-year-old woman presents with progressive abdominal distension over two years. CT shows copious loculated gelatinous fluid scalloping the liver surface and displacing bowel centrally, with thickened omentum. Exploratory findings include abundant jelly-like material throughout the peritoneal cavity. What is the most common primary source of this process?

• A Ovarian serous cystadenocarcinoma
• B Low-grade mucinous neoplasm of the appendix ✓
• C Colonic adenocarcinoma of the caecum
• D Gastric signet ring carcinoma

Explanation

Pseudomyxoma peritonei results from rupture or transcoelomic spread of a low-grade appendiceal mucinous neoplasm (mucinous cystadenoma or LAMN) in the great majority of cases, producing diffuse peritoneal mucin implants. Although ovarian mucinous tumours can mimic the picture, they are usually metastatic from the appendix rather than primary. Standard treatment is cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), not conventional systemic chemotherapy.

Reference: Bailey and Love Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.