Introduction
Peritoneal carcinomatosis is a rare late-stage manifestation of malignant disease, most commonly of gastrointestinal and pelvic origin, including gastric cancer, colorectal cancer, ovarian cancer, and other rare malignancies including primary peritoneal carcinoma and pseudomyxoma peritonei. Metastatic malignant disease of the abdomen is often complicated by diagnostic dilemmas and often has limited treatment options resulting in poor outcomes.
Discussion
Malignant disease of the abdomen and pelvis is often diagnosed in later stages due to the paucity of signs and symptoms in early disease. Peritoneal carcinomatosis is a finding of late-stage malignancy and is generally caused by gastric, colorectal and ovarian cancer. A rarer but notable cause is the mucin-producing pseudomyxoma peritonei. Patients with peritoneal carcinomatosis often report vague, non-specific symptoms and can even be asymptomatic. The diagnosis is usually made when the disease progresses significantly and causes complications such as pain, weight loss, and bowel obstruction. Diagnostic laparoscopy remains the gold standard for diagnosing malignant disease of the abdomen. Computed tomography is a suitable alternative but may miss early malignancy. Treatment options are often limited in peritoneal carcinomatosis but can include cytoreductive surgery, hyperthermic peritoneal chemotherapy, and systemic chemotherapy. In general terms, the prognosis is poor; however, depending on the primary malignancy, survival can range from weeks to years.
Consclusions
Peritoneal carcinomatosis is a poor prognostic indicator of malignant disease of the abdomen. This diagnosis must not be missed so that unnecessary interventions are avoided and prompt treatment can occur. The disease progresses quickly with significant morbidity, and therefore treatments that can enhance end of life care are of utmost importance.