ABSTRACT
Primary appendiceal carcinoma is extremely rare and is found in approximately 1% of
appendectomy specimens. When cancer is present, the most frequent histology is mucinous
adenocarcinoma. Neoplasms of the appendix that secrete mucin such as adenocarcinoma
may rupture, leading to intraperitoneal seeding of the peritoneum and producing the
clinical picture of pseudomyxoma peritonei (PMP). PMP is characterized by mucin-producing
neoplastic cells that have seeded the peritoneum from the ruptured viscous and continue
to secrete copious amounts of gelatinous material that accumulates in the abdomen
producing the characteristic “jelly belly.” A review of the medical literature revealed
no cases of PMP diagnosed at time of cesarean section. A previously healthy gravida
5, para 3 underwent cesarean section. Upon opening of the peritoneum, copious amounts
of gelatinous, yellow-tinged mucoid material was noted. A general surgeon was consulted,
and grossly necrotic-appearing appendix was noted. The patient underwent appendectomy
with right hemicolectomy. Pathology showed well-differentiated mucinous adenocarcinoma
of the appendix. PMP is associated with gastrointestinal and ovarian carcinomas. Although
somewhat rare, these cancers may occur in pregnancy. Because nonspecific abdominal
pain and increasing abdominal girth are common in pregnancy, patients' complaints
may go ignored. Early diagnosis of a potentially life-threatening disease requires
that clinicians expand the differential diagnosis and consider the possibility of
a malignant neoplasm presenting in the pregnant female.
KEYWORDS
Pseudomyxoma peritonei - mucinous adenocarcinoma of the appendix - pregnancy complications
- cancer
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