Intraperitoneal and Appendiceal Malignancies
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In patients with a history of appendiceal mucinous neoplasia, recognition of a multiloculated mucinous intraperitoneal collection with characteristic visceral scalloping on ultrasonography can provide an important diagnostic clue to PMP, even in the absence of discrete peritoneal or omental deposits.
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Background: Pseudomyxoma peritonei (PMP) is an uncommon condition characterized by the accumulation of mucinous material within the peritoneal cavity and is most commonly associated with appendiceal mucinous neoplasms. Although computed tomography (CT) and 18F-FDG PET/CT are commonly used for disease evaluation, ultrasonography may demonstrate characteristic morphological features that provide important diagnostic clues.Case summary: A 57-year-old man with a history of mucinous adenocarcinoma of the appendix, previously treated with diagnosticlaparoscopy, appendectomy, and chemotherapy, underwent follow-up imaging. Ultrasonography demonstrated a large multiloculated intraperitoneal collection containing multiple thin internal septations and low-level internal echoes in the right upper abdomen and perihepatic region, producing characteristic scalloping of the right lateral hepatic surface. No definite peritoneal nodules or omental thickening were identified. Subsequent 18F-FDG PET/CT demonstrated a corresponding loculated collection along the right lateral, anterior, and posteroinferior aspects of the right hepatic lobe, with low FDG uptake (SUVmax 1.80) and associated hepatic scalloping. Ultrasound-guided aspiration yielded thick, gelatinous mucinous material. Cytopathological examination demonstrated abundant extracellular mucin containing mucin-producing neoplastic epithelial cells, confirming peritoneal involvement by mucinous neoplasm.Conclusion: In patients with a history of appendiceal mucinous neoplasia, recognition of a multiloculated mucinous intraperitonealcollection with characteristic visceral scalloping on ultrasonography can provide an important diagnostic clue to PMP, even in the absence of discrete peritoneal or omental deposits. Dynamic correlation with CT or 18F-FDG PET/CT and image-guided aspiration may further aid diagnosis and characterization. BJusg. vol. 27, no. 1, June 2026, Page: 50-54
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@article{Bhattacharjee2026Pseudomyxoma,
title = {Pseudomyxoma Peritonei Secondary to Mucinous Adenocarcinoma of the Appendix: A Rare Case Report},
author = {Puja Bhattacharjee and Rahima Akter Sharmin and Arshad Hossain and Rumana Parveen and Nilufa Yasmeen and Sharmin Quddus},
journal = {Bangladesh Journal of Ultrasonography},
year = {2026},
doi = {10.3329/bjusg.v27i1.93204},
url = {https://doi.org/10.3329/bjusg.v27i1.93204}
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