A lecture for the four year MBBS

2.  National lead for GlobalSurg Collaborative
 National Lead with GlobalSurg® for FALCON trial
 Co-Prinicipal Investigator for NRPU grant
 Collaborator for European Coloproctology society, UK
 Colorectal Fellowship, Yonsei University, South Korea
 Fellow of College of Physicians & Surgeons, Pakistan
(Surgery)
 Fellow of Higher education authority of UK (FHEA)
 Member of Royal College of Surgeons, England (UK)
 Member of College of Physicians & Surgeons, Pakistan
(Surgery)
 Member Editorial Board, BMJ case reports since 2011-2014
 Reviewer for Rawalpindi Medical Journal since 2015
Dr. Ahmad Uzair Qureshi

3. Malignant Neoplasms of the
Peritoneum
• Primary malignant neoplasms
• Malignant mesothelioma,
• Primary peritoneal carcinoma
• Sarcomas (e.g., Angiosarcoma).
• Transperitoneal metastases originating from carcinomas of the
GI tract (especially the stomach, colon, and pancreas),
• The genitourinary tract (usually, ovarian), or, more rarely, an
extra-abdominal site (e.g., breast).

4. Malignant Neoplasms of the
Peritoneum
• Primary malignant neoplasms
• Malignant mesothelioma,
• Primary peritoneal carcinoma
• Sarcomas (e.g., Angiosarcoma).
• Transperitoneal metastases originating from carcinomas of the
GI tract (especially the stomach, colon, and pancreas),
• The genitourinary tract (usually, ovarian), or, more rarely, an
extra-abdominal site (e.g., breast).

5. Malignant Neoplasms of the
Peritoneum
• Primary malignant neoplasms
• Malignant mesothelioma,
• Primary peritoneal carcinoma
• Sarcomas (e.g., Angiosarcoma).
• Transperitoneal metastases originating from carcinomas of the
GI tract (especially the stomach, colon, and pancreas),
• The genitourinary tract (usually, ovarian), or, more rarely, an
extra-abdominal site (e.g., breast).

6. Malignant
Peritoneal Mesothelioma

11. Computerized Tomogram findings

12. Computerized Tomogram findings

15. Malignant Peritoneal
Mesothelioma
• The neoplasm tends to involve all peritoneal surfaces, producing masses and plaques of
tumor that are hard and white.
• In contrast to pseudomyxoma peritonei, local invasion of intra-abdominal organs, can
occur, and can create a malignant bowel obstruction.
• Extension of the mesothelioma into one or both pleural cavities is more likely .

16. Treatment - Historically
• Complete surgical resection is not possible
• Palliation - debulking of the tumor and enteroenterostomies
• No role of abdominal Radiotherapy
• No role of systemic chemotherapy

17. Treatment
• A multi-institutional data registry from eight institutions was created
•405patients treated with cytoreductive surgery and perioperative
intraperitoneal chemotherapy
• Chemotherapeutic regimens varied (cisplatin, mitomycin, and doxorubicin
• Morbidity rate was 46%,
• Mortality rate was 2%.
• Median survival 53 months.
• The 3- and 5-year survival rates were 60% and 47%, respectively

18. Carcinomatosis Peritonei

21. Pseudomyxoma Peritonei

22. Clinical features

25. Management
• Cytoreductive surgery and perioperative intraperitoneal
chemotherapy
• Peritonectomy
• Omentectomy
• Cholecystectomy
• Involved Organ