Pseudomyxoma peritonei: failure of activated trypsin to modify the course of the disease.

Abstract

PSEUDOMYXOMA peritonei is an uncommon disease with wide variability in degree of malignancy, marked differences in prognosis, and unpredictable response to therapy. Definitive surgery in itself is usually unsuccessful in arresting the disease. As adjuncts to surgery, a variety of therapeutic agents have been tried, including radiotherapy, radioactive gold, and nitrogen mustard. None has proved especially efficient. Part of the therapeutic problem obviously lies in the rarity of the condition and, therefore, in the paucity of reports concerning its management. Another part of the problem is related to the chronicity of the disease and the difficulty of being able to assess the value of therapy. A recent publication by Saegesser1made a therapeutic claim for the intraperitoneal use of activated pancreatic extract in the treatment of pseudomyxoma peritonei. This report prompted us to try this form of treatment on one of our patients with a long, well-documented history of pseudomyxoma