PERITONEAL METASTASES IN CHILDREN WITH CANCER

BACKGROUND. This study attempted to evaluate the childhood malignancie s associated with computed tomography (CT) detected peritoneal metasta ses as well as the diagnostic imaging characteristics of these metasta ses as shown on CT. METHODS, The authors reviewed all available pathol ogy specimens and abdominopelvic CT scans of patients identified as ha ving peritoneal metastases at three childhood cancer centers. Patient demographics, primary diagnosis, and CT characteristics of such metast ases were evaluated. RESULTS. Peritoneal metastases were identified by CT in 32 children with cancer either at diagnosis (n = 20) or up to 6 .2 years from diagnosis (n = 12). On CT, peritoneal disease appeared a s a mass in 26 cases, as studding in 11 cases, as peritoneal enhanceme nt in 15 cases, and as diffuse caking in 4 cases (15 patients had > 1 category of peritoneal metastasis). Thirteen patients had concurrent m etastases in other sites. Fourteen patients died of progressive diseas e at a median of 10 months from the time peritoneal metastases were id entified on CT. At last follow-up, the remaining 18 patients were aliv e, with follow-up ranging from 1 month to 9.7 years. As expected, peri toneal metastases were identified in patients with germ cell tumors an d colon carcinoma. However, they also were observed in patients with e pithelioid carcinoma, leiomyosarcoma, pineoblastoma, neuroblastoma, me lanoma, and peripheral neuroectodermal tumor. CONCLUSIONS, Peritoneal metastases have variable appearance on CT, but most commonly appear ma ss-like. They are associated with a wider range of primary diagnoses t han reported previously. The outcome varies with the type of the prima ry tumor and its responsiveness to existing therapies. (C) 1998 Americ an Cancer Society.