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Hereditary Diffuse Gastric Cancer
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
If cancer metastasizes to other sites, symptoms may include hepatomegaly (enlarged liver), yellowing of the eyes and skin (jaundice), Virchow node (left supraclavicular adenopathy), Sister Mary Joseph node (periumbilical nodule), Irish node (left axillary node), Krukenberg tumor (ovary mass), Blumer shelf (cul-de-sac mass), ascites (peritoneal carcinomatosis, an abnormal buildup of fluid in the peritoneum), skin nodules (firm lumps under the skin), and fractures (broken bones).
Embryology and anatomy of the peritoneal cavity
Published in Wim P. Ceelen, Edward A. Levine, Intraperitoneal Cancer Therapy, 2015
The subserosa is one layer of connective tissue beneath the serosa, which is partially adherent and partially loosely connected to the serosa. The anatomic continuity of the subserosa enables the spread of diseases, not only between the intraperitoneal structures but also between intra- and extraperitoneal spaces. A clinical example would be Cullen’s sign, which is the result of a subserosal spread of inflammation. This phenomenon also occurs during acute severe pancreatitis and is characterized by the spreading of exudates to the ventral abdominal wall by the inflamed hepatoduodenal ligament and along the falciform ligament. Free air, inflammation, tumors, or other proliferative diseases can also spread along the subserosa. Clinically significant as well is the so-called Sister Mary Joseph nodule in the umbilicus due to peritoneal spread from gastric or ovarian cancers.
Are positron emission tomography-computed tomography (PET-CT) scans useful in preoperative assessment of patients with peritoneal disease before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)?
Published in International Journal of Hyperthermia, 2018
Weining Wang, Grace Hwei Ching Tan, Claramae Shulyn Chia, Thakshayeni Skanthakumar, Khee Chee Soo, Melissa Ching Ching Teo
Of the 58 (63.7%) patients where PET-CT was ‘not beneficial’, 31 (53.4%) showed FDG-avid lesions that coincided with the peritoneal lesions seen on the CT/MRI scans but did not provide any additional information. In 25 (43.1%) patients, the peritoneal disease itself had minimal or no FDG avid uptake and hence, the PET scan similarly provided no additional information. Two patients (3.4%) had no disease on the PET-CT and CT/MRI, but had disease noted intra-operatively. In one of the cases, the patient had laparotomy done as he was symptomatic and had raised tumour markers and in the other case, the patient had a biopsy-proven Sister Mary Joseph nodule and was hence scheduled for laparotomy with a plan to proceed with CRS and HIPEC.