A Case of Pseudomyxoma Peritonei due to Pancreatic Mucinous Carcinoma

Abstract

Pancreatic mucinous carcinoma is a rare tumor and accounts for 0.6 % of all pancreatic tumors. We present a case of pseudomyxoma peritonei derived from pancreatic mucinous carcinoma, together with a review of the literature. The case involved a 78-year-old man who was referred to our hospital for close examination of right lateral abdominal pain. An abdominal CT scan showed a cystic tumor about 6 cm in diameter at the pancreatic body and tail. MRI scan also revealed a cystic tumor having the thick wall and septa within it. Furthermore, images suggesting fluid collection were seen in the omental bursa, liver surface, and right juxtacolic groove. Intraomental penetration of intraductal papillary mucinous adenocarcinoma was diagnosed and resection of the pancreatic body and tail was performed. Upon laparotomy, we confirmed mucus collection in the omental bursa surrounding the tumor, in the perihepatic area and the Douglas pouch. Pseudomyxoma peritonei was thus diagnosed. The histopathological diagnosis was mucinous carcinoma. After the operation, he developed pancreatic fistula at the surgical stump of the pancreas, but it was relieved conservatively. Abdominal CT scan performed 9 months after the operation showed only a small amount of ascites around the liver and the patient who is on internal S-1 regimen has been followed in our clinic.