E1755. Primary Peritoneal Serous Carcinomas: Spectrum of Imaging Findings
Authors
Kyeong Ah Kim;
Korea University Guro Hospital
Objective:
Primary peritoneal serous carcinoma (PPSC) is an uncommon malignancy that is pathologically and clinically indistinguishable from ovarian serous carcinomas. However, it is discernible that ovaries are either spared or only superficially invaded. Accounting for the similarities to ovarian serous carcinomas, the prevalence of PPSC is underestimated, with approximately 15% of pathologically proven ovarian serous carcinomas actually being PPSC. This study aimed to evaluate the spectrum of radiological findings of PPSC, in association with its clinical features.
Materials and Methods:
All patients were women with a mean age of 61.8 years. CA-125 levels were elevated in all patients. The distribution pattern of PPSC was classified as type 1 (diffuse; n = 14), 2 (localized pelvic; n = 6), or 3 (mixed; n = 5). The mean sizes of the dominant lesions for types 1, 2, and 3 were 2.3 cm, 8.7 cm, and 4.1 cm, respectively. Ascites was present in all patients with both PPSC types 1 and 3 and in one patient with type 2. Metastatic lymphadenopathy and calcification was present in three and two patients, respectively. FIGO stages at the time of diagnosis were stage II (n = 6), III (n = 18), and IV (n = 1).
Results:
All patients were women with a mean age of 61.8 years. CA-125 levels were elevated in all patients. The distribution pattern of PPSC was classified as type 1 (diffuse; n = 14), 2 (localized pelvic; n = 6), or 3 (mixed; n = 5). The mean sizes of the dominant lesions for types 1, 2, and 3 were 2.3 cm, 8.7 cm, and 4.1 cm, respectively. Ascites was present in all patients with both PPSC types 1 and 3 and in one patient with type 2. Metastatic lymphadenopathy and calcification was present in three and two patients, respectively. FIGO stages at the time of diagnosis were stage II (n = 6), III (n = 18), and IV (n = 1).
Conclusion:
PPSC shows a diverse spectrum of imaging findings. Type 1 PPSC can mimic diffuse peritoneal carcinomatosis or tuberculous peritonitis. Both PPSC types 2 and 3 can have similar radiological findings similar to those of ovarian cancer. Type 2 PPSC manifests with young age, larger tumor sizes, few amounts of ascites, and lower FIGO stages.
