Lecture notes for medical students

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Peritoneal Malignancy

3. Classification

4. Classification
• Primary: originate de novo from the
peritoneal tissues
• Secondary: Invade or metastasize into the
peritoneum from adjacent or remote organs

5. Etiology

6. Etiology
• Idiopathic
• Congenital
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative

7. Primary
• Malignant mesothelioma,
• Benign papillary mesothelioma
• desmoplastic small round cell tumors,
• peritoneal angiosarcoma,
• leiomyomatosis peritonealis disseminata
(LPD)
• peritoneal hemangiomatosis.
• Primary peritoneal carcinoma:ovarian
cancer arising in women several years after
bilateral oophorectomy.

8. Clinical Features

9. Clinical Features
• Demography
• Symptoms
• Signs
• Prognosis
• Complications

10. Demography

11. Demography
• Rare
• Sex
– Primary peritoneal carcinoma t occurs almost
exclusively in women.
– Malignant mesotheliomas show extreme male
predominance (93% in one series).

12. Prognosiis

13. Prognosiis
• Survival is poor

14. Clinical Features

15. Clinical Features
• Abdominal pain
• Ascites
• Weight loss
• An abdominal mass

16. Diagnostic Studies

17. Diagnostic Studies
• Laboratory Studies
• Imaging Studies
• Histopathology

18. Histopathology

19. Histopathology
• peritoneal lavage cytology
• Laparoscopy is minimally invasive and
allows for safe, directed peritoneal lavage
• Open abdominal exploration and palpation
are extremely sensitive for 1- to 2-mm
peritoneal nodules.

20. Diagnostic Studies

21. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Nuclear scan

22. Imaging Studies

23. Imaging Studies
Ultrasonography finding
• Ascites
• Fixing together of bowel loops
• Thickening of mesentery
• Omental matting

24. Imaging Studies
CT scan
• Ascites
• Omental caking
• Diffuse enhancement with nodular
thickening of the parietal peritoneum of the
pelvis
• Normal-sized ovaries, with or without a fine
enhancing surface nodularity of the ovary

25. Other Studies
Radionuclide scan studies
 hemangiomas

26. Differential Diagnosis

27. Differential Diagnosis
• Lymphangioma
• mesenteric-omental cysts
• ovarian cystadenoma
• Cystadenocarcinoma
• cystic teratoma
• pseudomyxoma peritonei
• cystic smooth muscle tumors
• endometriosis.

28. Management

29. Management
• Surgical cytoreduction
• Intraperitoneal perioperative chemotherapy
• Hyperthermia
• For patients with unresectable or recurrent
malignant mesothelioma, palliative
systemic chemotherapy

30. Management
• Heated chemotherapeutic drugs used
intraoperatively include the following:
• Cisplatin
• Mitomycin
• Doxorubicin

31. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

32. Get this ppt in mobile

33. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
=0
• https://www.facebook.com/doctorpradeeppa
nde/?ref=pages_you_manage