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Surgical staging was considered complete when including peritoneal washing, multiple peritoneal biopsies, omental biopsy and biopsy of any suspicious area.
The standard surgical procedure was total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, multiple peritoneal biopsies and peritoneal washings with cytology.
No intraoperative peritoneal implant or suspicious areas for malignancy were found; so multiple peritoneal biopsies for surgical staging was not given.
In line with the standard treatment program in West Sweden, patients were treated by total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, multiple peritoneal biopsies, and peritoneal washings with cytology.
Guidelines for surgical management of these lesions are similar to those of ovarian malignancy and include laparotomy with peritoneal washing, hysterectomy and bilateral salpingoophorectomy, and multiple peritoneal biopsies [ 17].
The conventional surgical modality for patients with early-stage EOC is based on hysterectomy and bilateral salpingo-oophorectomy with peritoneal sampling (peritoneal washing, omentectomy, multiple peritoneal biopsies, and the removal of peritoneal implants) regardless of lymph node resection.
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Multiple liver and peritoneal biopsy specimens revealed fibrinoid necrosis, associated with granulomatous reaction and a high concentration of eosinophils in the liver, (Fig. 2) accompanied by markedly inflamed peritoneal tissue with eosniphilic infiltration.
Peritoneal fluid or cytological washing from the abdominal cavity was sent for pathology, but no standard peritoneal biopsies or lymphadenectomy was carried out in either group.
The surgical approach consists of total abdominal hysterectomy, bilateral salpingo-oophorectomy, and infra-colic omentectomy, appendicectomy, peritoneal washings, and peritoneal biopsies [43, 44].
Sixteen months after reoperation, an abdominal CT scan showed multiple peritoneal metastases.
Peritoneal biopsies will be obtained on occasion of intraabdominal surgery.
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