Professional paper
Low Grade Peritoneal Mucinous Carcinomatosis Associated with Human Papilloma Virus Infection: Case Report
Zoran Gatalica
; Department of Pathology, Creighton University Medical Center, Omaha, Neb, USA
Jason M. Foster
; Creighton Cencer Center, Omaha, Neb, USA
Brian W. Loggie
; Creighton Cencer Center, Omaha, Neb, USA
Abstract
Pseudomyxoma peritonei is a clinical syndrome characterized by peritoneal
dissemination of a mucinous tumor with mucinous ascites. The vast
majority of the pseudomyxoma peritonei are are associated with mucinous
neoplasms of the appendix. We describe a case of pseudomyxoma
peritonei associated with mucinous adenocarcinoma of the cervix in a 60-
year-old woman. The patient developed low grade mucinous peritoneal
carcinomatosis 8 years after hysterectomy for cervical adenocarcinoma.
No other primary mucinous tumor was identified and peritoneal carcinomatosis
tested positive for high-risk human papilloma virus (HPV),
showing both integrated and episomal pattern. HPV has been previously
associated with development of cervical carcinomas (both squamous and
mucinous) but neither has cervical adenocarcinoma nor HPV been implicated
in development of pseudomyxoma peritonei. To the best of our
knowledge, this is the first description of HPV-associated malignancy
presenting as pseudomyxoma peritonei.
Pseudomyxoma peritonei is characterized by peritoneal dissemination
of mucin-producing neoplasms originating from
the appendix, colon, and ovaries (1-3). The vast majority of
tumors arise in the appendix. Benign appendiceal neoplasms
(adenomas) may lead to the peritoneal dissemination, ie,
disseminated peritoneal adenomucinosis, while malignant
appendiceal neoplasms may lead to peritoneal mucinous
carcinomatosis. Disseminated peritoneal adenomucinosis
is characterized by scant mucinous epithelium that displays
little or no cellular atypia, abundant mucin production,
variable fibrosis, and inflammation. On the other hand,
peritoneal mucinous carcinomatosis is characterized by mucin-
producing glands and cells that exhibit cytological and
architectural atypia characteristic of carcinoma (including
signet ring variants). Peritoneal mucinous carcinomas with
Keywords
pseudomyxoma peritonei; HPV; adenocarcinoma; cervix
Hrčak ID:
35104
URI
Publication date:
15.10.2008.
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