Disseminated peritoneal adenomucinosis associated with a panperitonitis-like onset: Report of a case

A 59-year-old man was admitted to our department due to a fever of unknown origin. Abdominal ultrasonography and computed tomography showed a large cy stic mass in the lower abdomen and a massive amount of abdominal fluid. A l aparotomy was performed under a diagnosis of panperitonitis. Diffuse pyogen ic gelatinous ascites and a large cystic mass with a grayish wall, and a ha rd solid lesion in part were found. The microscopic findings of the hard so lid lesion showed calcification, osteogenesis, and focal epithelial prolife ration in a tiny area consisting of mucinous cells with no significant cyto logic atypia. The remaining part of the cystic wall and small cystic lesion s were hyalinized, fibrous, or necrotic tissue. Since a total resection of the masses was not possible, the patient received adjuvant chemotherapy wit h cisplatin followed by the administration of mitomycin C and 5-fluorouraci l. An abdominal fistula with the excretion of pyogenic gelatinous fluid occ urred, but the patient is still alive and doing well over 2 years postopera tively. The primary site of this tumor could unfortunately not be identifie d.