Application of Advanced Multimodality Care to Pseudomyxoma Peritonei Patient: Report of First Patient Treated at a Tertiary Center

Abstract

Pseudomyxoma peritonei following dissemination of appendicealmucinous neoplasms is slowly progressive but inevitably a lethal condition. It is locally invasive and does not lead to lymph node or distant metastasis making it amenable for more radical procedures. We present a case of pseudomyxoma peritonei treated by Cytoreductive surgery(CRS)and heated intraperitoneal chemotherapy(HIPEC) with Mitomycin C (12.5mg/m2 ) at 41.50 C. This was followed by five cycles of early postoperative intraperitoneal chemotherapy (EPIC) with 5FU (650 mg/m2) over 5 days. Patient underwent standard Peritonectomy procedure combined with resection of gallbladder, Spleen, subtotal colectomy and resection of part of small bowel. Blood loss during theprocedure was 4000ml. Histopathology revealed Pseudomyxoma peritonei (hybrid type). The patient recuperated well and was discharged and now is living a productive life. Peritonectomy with perioperative intraperitoneal chemotherapy is the current standard of treatment for appendiceal tumors with peritoneal dissemination which offers a hope of disease free long survival in such patients.