Primary serous papillary carcinoma of the peritoneum: CT findings

AIM: To describe the computed tomography (CT) findings of primary serous pa pillary carcinoma of the peritoneum. MATERIAL AND METHODS: The clinical data and imaging studies of 36 women age d 37-85 years with primary papillary serous carcinoma of the peritoneum wer e retrospectively evaluated. Twenty-seven patients presented with general a bdominal complaints; all had elevated levels of CA-125. Thirty-two women we re post-menopausal, four had had bilateral salpingo-oophorectomy. RESULTS: The most common findings on pre-operative abdominal CT, performed in 30 patients, were a variable amount of ascites (n = 29), omental involve ment (n = 28), irregular parietal peritoneum thickening (n = 22) and mural thickening of the sigmoid colon (n = 10). Thoracic findings included enlarg ed cardiophrenic nodes (n = 15) and pleural effusion (n = 11). Six patients had unilateral or bilateral adnexal masses of soft tissue density, which p roved to be surface serous papillary carcinoma. CONCLUSION: Diffuse peritoneal disease on CT in patients with normal-sized ovaries or following bilateral salpingo-oophorectomy, with elevated level o f serum CA-125, but without an identifiable primary tumour, should suggest the diagnosis of primary serous papillary carcinoma of the peritoneum. Asso ciated adnexal masses or focal bowel wall thickening may be seen, represent ing surface involvement by this tumour. (C) 2001 The Royal College of Radio logists.