Mucinous Cystadenocarcinoma and Diffused Carcinomatosis with Unknown Origin in Postmenopausal Woman-A Case Report and Review of Literatures

Abstract

Summary: We here to report a case of adenocarcinoma with severe and diffused intra-abdominal carcinomatosis (IAC) of unknown origin. A 67-year-old female, visited our hospital due to progressive low abdominal distension, poor appetite and umbilicus abscess for weeks. The abdominal ultrasound showed mild liver cirrhosis with massive ascites, and thick omentum cake. Others non-invasive examinations including CA-125 (＞800), panendoscope and colofibroscope (both showed negative). The abdominal computerized tomography showed thick omentum cake, liver and lung metastasis, and an adnexa mass which favor the primary ovarian malignancy. During operation, massive ascites, disseminated carcinomatosis (including umbilicus), severe intra-abdominal adhesion and bilateral ovarian enlargement were noted. The frozen sections from omentum, umbilicus, ovaries, bowels, colon and peritoneum showed metatstatic adenocarcinoma. Due to the advanced stage of the disease and the severe pelvic adhesion, conservative intervention including Port A insertion, conservative colostomy, hysterectomy with bilateral salpingoophorectomy were done. The final histopathological report showed metastatic mucinous adenocarcinoma with unknown origin, favoring from the gastro-intestinal tract.