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Epithelial ovarian cancer
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
The omentum is frequently the site of massive metastatic deposits of disease and may cause the presenting symptoms at the time of diagnosis. An omental “cake,” as it is commonly referred to, may be found at the junction of the greater omentum and the transverse colon. Although initial assessment may give the appearance of gross involvement of the transverse colon, this is usually not the case, and the tumor mass can be carefully mobilized and resected without the need for a transverse colectomy. Care should be taken to assess whether the omentum is adherent to the anterior abdominal wall peritoneum, as this peritoneal layer can be stripped in continuity with the omentum if necessary.
Benign and malignant ovarian masses
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
Assessment should include examination of supraclavicular, axillary and inguinal nodes, breast examination, chest examination (pleural effusion) and abdominal examination, including assessment of liver size. In women presenting with the above symptoms, a pelvic examination (including per-rectal examination) is mandatory. The presence of a solid, irregular mass is highly suspicious, particularly when associated with an upper abdominal mass (omental cake).
Gastric cancer and intraperitoneal chemotherapy
Published in Wim P. Ceelen, Edward A. Levine, Intraperitoneal Cancer Therapy, 2015
Valerie Francescutti, John M. Kane, Joseph J. Skitzki
Although definitive patient selection criteria have yet to be established, there are general considerations that should be taken into account when considering cytoreduction and IP chemotherapy for treating gastric PC based upon current data. For example, patients deemed to have extensive PC that would preclude the potential for a complete or near complete cytoreduction are unlikely to improve from an extensive procedure and risk significant morbidity. Patients with significant ascites or omental cake are likely to have diffuse and potentially extensive disease (Figure 22.2). Patients who manifest any evidence of hematogenous metastasis are also unlikely to receive benefit from cytoreduction and IP chemotherapy. Accordingly, poor performance status in patients who cannot tolerate a major surgery is prohibitive. Also, significant progression of disease while receiving systemic chemotherapy is often a harbinger of poor survival and outcomes.
Changing patterns of referral into a family history clinic and detection of ovarian cancer: a retrospective 10-year review
Published in Journal of Obstetrics and Gynaecology, 2022
K. G. Smallwood, S. Crockett, V. Huang, V. Cullimore, J. Davies, G. Satti, A Phillips
Two patients developed primary peritoneal carcinoma subsequent to risk reducing surgery, with an interval from surgery to diagnosis of 40 and 72 months respectively. Neither of these patients were found to have STIC at initial surgery. Patient 1 presented with abdominal pain; however little treatment information is available as she was treated at another unit. Patient 2 presented to the upper GI team on a two week wait referral with dyspepsia. She had a normal oesophagogastroduodenoscopy, however a CT scan showed significant omental cake. Primary peritoneal cancer was diagnosed on ultrasound guided biopsy and the patient was worked up for cytoreductive surgery. Unfortunately, she was deemed unfit due to cardiac problems and therefore was offered primary chemotherapy. Both patients died during the follow up period at 6 and 43 months post diagnosis respectively. These are the only deaths in our cohort. The rate of developing PPC following risk reducing BSO in our cohort was therefore 0.7%. Patient characteristics are found in Table 4.
Pseudomyxoma peritonei and appendiceal carcinoma with peritoneal metastases: current management strategies
Published in Expert Opinion on Orphan Drugs, 2018
Understanding the radiology of PMP and mucinous appendiceal neoplasms is dependent upon the knowledge of the natural history of a perforated appendiceal neoplasm. These tumors may be low grade, even appearing histologically benign, to the pathologist. The work of Jacquet and colleagues attempted to establish criteria by which the preoperative CT scan could be used to help select patients for long-term benefit from treatment [22]. Figure 3 shows a preoperative CT in a patient who has an immense volume of mucinous ascites and tumor. However, the small bowel is compartmentalized beneath the very large omental cake. The small bowel and its mesentery are not infiltrated by the mucinous tumor. This patient would be expected to undergo a complete cytoreduction.
Clinical presentation of peritoneal tuberculosis
Published in Baylor University Medical Center Proceedings, 2023
Nazli Begum Ozturk, Christos Tsagkaris, Naile Dolek, Raim Iliaz
Contrast-enhanced computed tomography (CT) of the abdomen and pelvis revealed diffuse thickening and nodularity of the peritoneum, stranding and thickening of the omentum with omental cake appearance, and normal liver parenchymal findings (Figure 1a). CT was suggestive of peritoneal carcinomatosis, with a differential diagnosis of PT. Esophagogastroduodenoscopy and colonoscopy were unremarkable. Serum levels of carcinoembryonic antigen: 1.31 ug/L (<5 ug/dL), alpha fetoprotein: 3.64 ug/dL (0–8.04 ug/dL), and CA-19-9: 9.04 U/mL (0–37 U/mL) were within normal ranges. Thorax CT revealed pleural effusion in the left hemithorax with no signs of pulmonary TB.