Fact-sheet: Peritoneal metastases


Updated on 03/25/2020 at 11:28 AM

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Definition

  • Malignant peritoneal or omental lesions arising from a primary malignant tumor.
  • Primary sites: colon, ovary, Stomach, Pancreas, and bladder.

Clinical features

  • Ascites
  • Sister Mary Joseph nodule
  • Impaired general condition

Ultrasound

Omental caking and peritoneal nodules.

CT

  • Irregular peritoneal thickening
  • Peritoneal nodular lesions (occasionally calcified)
  • Ascites
  • Hepatic and splenic scalloping
  • Retraction of the mesenteric root
  • After contrast administration: intense enhancement

MRI

  • Omental caking
  • After gadolinium administration: intense enhancement of the lesions.

Nuclear medicine

PET-CT hypermetabolism

Management

  • Treatment of the primary cancer (often advanced)
  • HIPEC (Hyperthermic Intraperitoneal Chemotherapy)

Differential diagnosis

  • Pseudomyxoma peritonei
  • Peritoneal mesothelioma