PubMed1987
Having considered their 13 cases of pseudomyxoma peritonei where mucin is found in the peritoneum, the authors reviewed 420 cases abstracted from the literature. It is a rare condition (2 out of every 10,000 laparotomies) and is three times more common in women than in men. the mean age is 53 years. The spontaneous evolution of the condition before the diagnosis is made is about 21 months, as the aetiology and histology may be confusing. Diagnosis is made easier by paracentesis, but ultrasound and now tomodensitometry, are very helpful. It is interesting that in 5 out of the 13 cases there was a rise in carcino-embryonic antigen (C.E.A.) both in the gelatinous material and in the serum. Five cases out of the 5 appendix tumours or tumours of the ovary which were benign showed this feature. The level of C.E.A. in the serum was weak (50-150 ng/ml) when the quantity of gelatinous material was large (48,000-70,000 ng/ml). In one case a step-ladder rise in C.E.A. corresponded to clinical changes. Finally, the proof that C.E.A. was secreted by the cells of a cyst adenoma of the ovary could have been brought about by the phenomenon of immuno-competition. The following therapeutic measures are proposed: first surgery and then the use of proteolytic enzymes with, in benign lesions, estimations of C.E.A. and tomodensitometry. This last examination makes it possible, in cases of recurrences, to separate the "young" forms which can still be sensitive to enzyme treatment, from the "old" forms which are resistant to such treatment and may be respond better to chemotherapy.