Peritoneal adenocarcinoma

Adenocarcinoma, peritoneal, primary 8 Carcinoma, small cell, prostate 58... 

In an animal study of rats exposed by inhalation to ethylene oxide at 10, 33, or 100 ppm for approximately two years (245), and in a separate chronic rat study in which rats were exposed to 50 or 100 ppm of ethylene oxide (240), increased incidences of mononuclear cell leukemia, peritoneal mesothelioma, and various brain tumors have been reported. In an NTP (246) two-year inhalation study of mice at 50 and 100 ppm, alveolar/bronchiolar carcinomas and adenomas, papillary cystadenomas of the harderian gland, and malignant lymphomas, uterine adenocarcinomas, and mammary gland tumors were increased in one or both exposure groups. 

Azumi and associates used immunohistochemistry to study 33 mesotheliomas (32 pleural, 1 peritoneal, 18 epithelial, 10 biphasic, 4 sarcomatoid, 1 desmoplastic) and 37 adenocarcinomas for hyaluronate. Three of 37 (8.1%) adenocarcinomas and all mesotheliomas immunostained for hyaluronate. The location of the staining reaction in the mesotheliomas was membranous in 30 cases, cytoplasmic in 21 cases, and membranous and cytoplasmic in 19 cases. The staining reaction in mesotheliomas was classified as moderate or greater in 27 of 33 (81.8%) cases. The authors concluded that the demonstration of hyaluronate should be considered an important adjunct to other immunohistochemical tests and electron microscopy in diagnosing epithelial mesotheliomas. 

Bollinger DJ, Wick MR, Dehner LP, et al. Peritoneal malignant mesothelioma versus serous papillary adenocarcinoma A his-tochemical and immunohistochemical comparison. Am J Surg Pathol. 1989 13 659-670. 

Einally, it should be noted that while many serous adenocarcinomas of endometrium resemble ovarian serous carcinomas, there are some important differences. We will discuss these differences in the Ovary section. The most important of these is infrequent WTl expression in endometrial serous carcinomas (seen in at most 20% to 30% of such cases) and the very common diffuse nuclear expression of WTI in ovarian, tubal, and primary peritoneal examples (at least 70% to 80% of such cases). 

Includes ovarian, peritoneal, and tubal serous carcinomas. Except in FIGO grade 3 endometrioid adenocarcinoma, about 50% of which express significant ER and PR. 

Hepatocyte nuclear factor-ip (HNF-ip) is a transcription factor that directly binds to DNA and is shown to be unregulated in ovarian clear cell carcinomas for unknown reasons. Mesothelial cells and non-clear cell adenocarcinomas are shown to be negative. A distinct nuclear staining is shown in clear cell carcinomas and is considered to be a positive result. HNF-ip is useful in peritoneal fluid cytology to distinguish clear cell carcinomas from other adenocarcinomas. Future studies are needed to evaluate the sensitivity and specificity of this marker in other cytology samples. 

Metastatic involvement of peritoneum (peritoneal carcinomatosis) is by far the most common peritoneal tumor (Walsh and Williams 1971 Bell and Scully 1990). Tumors that preferentially metastasize to the peritoneum include the following adenocarcinomas stomach intestine (colon-rectum) gallbladder or biliary tree pancreas breast lung ovary and uterus (Runyon et al. 1988) as well as lymphoma... 

Fig. 10.4. Calcifications in ovarian cancer. Multiple plaquelike calcifications are demonstrated within a mixed solid and cystic bilateral ovarian tumor. They also cloak the peritoneal surface of the uterus (U). These small calcifications present psammoma bodies and are found in approximately 10% of serous ovarian adenocarcinomas in CT.B, bladder...

Fig. 10.14a,b. Stage IV ovarian cancer. CT in the pelvis (a) and lower thorax (b).At the time of diagnosis, the patient presented with bilateral ovarian tumors encasing the uterus (a). Furthermore, left cardiophrenic lymph node enlargement and a pleural mass (arrow) were found (b). Biopsy of the latter confirmed metastases from ovarian adenocarcinoma. No evidence of ascites or peritoneal dissemination was found at imaging and surgery... 

Tumorigenicity A 47-year-old patient with long-standing Crohn s disease, without a family history of colorectal cancer, who had previously had low-grade dysplasia that was not confirmed in subsequent studies, developed an adenocarcinoma of the colon with peritoneal invasion after a fourth infusion of infliximab [64 ]. 

A wide variety of solid tumors are able to disseminate to peritoneal surfaces. Some of these grow in just the abdominal cavity and lack the capacity to produce distant metastases. These malignancies, such as mucinous adenocarcinoma of the colon or appendix, grow at the surface of the peritoneum not infiltrating deeper tissue. Due to these reasons this tumor type is an excellent candidates for a cytoreductive approach. 

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