Pseudomyxoma Peritonei: Exploring an unusual clinical presentation – A case report

TL;DR

A 42-year-old woman with a rare condition called pseudomyxoma peritonei showed unusual symptoms and was successfully treated with surgery and chemotherapy.

Contribution

This case report highlights an unusual clinical presentation of pseudomyxoma peritonei and the challenges in its diagnosis.

Findings

The patient presented with chronic diarrhea and abdominal distension, which led to the discovery of pseudomyxoma peritonei.

Diagnostic laparoscopy revealed a perforated appendicular mass and mucin ascites.

Treatment with cytoreductive surgery and heated intraperitoneal chemotherapy resolved the patient's symptoms.

Abstract

Pseudomyxoma peritonei (PMP) is a rare clinicopathological condition characterised by mucin-producing peritoneal and omental deposits with an estimated incidence of 1–2 cases per million per year. We report a 42-year-old female patient who presented to a tertiary care hospital in Muscat, Oman, in 2023 due to a 7-year history of chronic diarrhoea associated with progressive abdominal distension over the past 2 years. Her assessment was significant for ascites. No neoplastic lesions were found on the upper and lower gastrointestinal scopes. A diagnostic ascitic tapping revealed a free flow of gel-like thick, yellowish fluid. A diagnostic laparoscopy showed a perforated appendicular mass with diffuse peritoneal nodules and mucin ascites. Subsequently, the patient underwent cytoreductive surgery with heated intraperitoneal chemotherapy. On follow-up, the patient's abdominal distension and diarrhoea had resolved. This case reports an unusual presentation of a very rare disorder and highlights the challenge of diagnosing PMP.

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