Abstract
Pseudomyxoma peritonei (PMP) is an uncommon condition arising from mucus-producing appendiceal or ovarian tumors. We experienced two cases of PMP related to pregnancy.
Case 1 : A 37-year-old primagravid woman was diagnosed with PMP during a laparoscopic examination for an ovarian tumor, and was pregnant one year later by in vitro fertilization (IVF). She was referred to our hospital at 19 weeks gestation, and admitted at 32 weeks gestation because of increasing risk to the fetus from a massive abdominal tumor. Reductive surgery was performed under spinal anesthesia to maintain the pregnancy. Caesarian section was performed at 35 weeks gestation, and the metastatic right ovary was removed simultaneously. Complete cytoreductive surgery was performed 7 months after delivery. Appendectomy, greater and lesser omentectomy, hysterectomy, left salpingo-oophorectomy, splenectomy, cholecystectomy and radical peritonectomy were performed. No recurrence is observed 22 months after surgery.
Case 2 : A 34-year-old primagravid woman was diagnosed with PMP during a laparoscopic examination for ascites of unknown origin, and an appendectomy was subsequently performed. One year later she was pregnant by IVF. She was referred to our hospital at 10 weeks gestation, and a caesarian section was performed at 37 weeks gestation. Three months later, complete cytoreductive surgery including low anterior resection of the rectum, hysterectomy, bilateral salpingo-oophorectomy, greater and lesser omentectomy, splenectomy, cholecystectomy and radical peritonectomy were performed. Although serum tumor markers were within normal range, a small amount of ascites was detected 20 months after surgery.
Conclusions : Full knowledge is required to manage PMP patients during pregnancy.
