A Case of Appendiceal Peritoneal Pseudomyxoma Peritonei Presented with Simultaneous Umbilical Metastasis

Abstract

A 44-year-old woman was referred to our department for a subcutaneous mass in the umbilical region. She had been aware of the mass for a year. At first we had thought it as a ureteral duct cyst and performed an abdominal CT scan for detailed examination. The CT findings revealed a multifocal cystic mass in the appendix. Laparoscopic surgery was performed with a preoperative diagnosis of an umbilical mass and low-grade appendiceal mucinous neoplasm (hereinafter referred to as LAMN). The appendiceal tumor was partially ruptured and a localized jelly-like ascites effusion was observed around the ileocecal area. The ileocecal area was resected with the peritoneum covering the ileocecal area in order to prevent the spread of ascites. The pathological findings were compatible with the diagnosis of LAMN and peritoneal pseudomyxoma peritonei (PMP)including umbilical cysts. The patient underwent adjuvant chemotherapy and has been recurrence-free for 1 year and 4 months. We report a case of PMP presented with simultaneous umbilical metastasis, which is extremely rare.