A Case of Papillary Serous Adenocarcinoma of the Peritoneum Diagnosed by Laparoscopic Biopsy

Abstract

Primary peritoneal serous papillary adenocarcinoma is a rare disease that histologically resembles its ovarian counterpart. Diagnostic imaging often fails to clearly reveal a mass, making preoperative diagnosis difficult. Laparoscopy is useful to determine the therapeutic strategy. A 78-year-old woman was referred to our hospital with chief complaints of abdominal discomfort and weight loss. Abdominal CT revealed a thickened greater omentum and a small amount of ascitic fluid. Pelvic MRI also showed a thickened peritoneum, suggestive of peritoneal dissemination on the greater omentum and pelvic margin, but failed to detect ovarian or other organ lesions. Since examination of the upper and lower gastrointestinal tract revealed no lesions, we performed laparoscopic peritoneal biopsy for suspected primary peritoneal serous adenocarcinoma. During surgery, the greater omentum showed a large mass-like appearance, and a part of the omentum was biopsied with an ultrasonic coagulation incision apparatus. The patient had no postoperative complications, and was histopathologically diagnosed with serous adenocarcinoma. After chemotherapy, she underwent abdominal omentectomy with bilateral adnexectomy, and remains alive. Herein, we report a patient with primary peritoneal serous adenocarcinoma diagnosed by laparoscopic biopsy.