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Sixteen months after reoperation, an abdominal CT scan showed multiple peritoneal metastases.
At 11 months after initial resection, computed tomography (CT) revealed a solitary liver metastasis measuring 3.1 cm in diameter and multiple peritoneal metastases, of which the largest was 5.5 cm in diameter.
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The patient died of multiple liver, lung, and peritoneal metastases 3 months after surgery.
Intraoperative examination showed disseminated small multiple peritoneal nodules and a few superficial liver metastases up to 2 cm in size.
Using extensive visceral peritoneal metastases, extensive involvement of the upper abdomen, extensive small bowel involvement and multiple liver metastases as criteria of unresectability, Angioli et al reported that 61% of patients were considered operable on the basis of diagnostic laparoscopy [ 12].
Since that time, multiple publications confirming the efficacy of the combination of cytoreductive surgery and perioperative chemotherapy to benefit patients with established colorectal peritoneal metastases have been published.
The patient had peritoneal metastases develop during the early postoperative period, and a postoperative CT only 2.5 months later showed a lung metastasis and multiple liver metastases occupying half of the liver.
Delayed enhancement after gadolinium improves detection of peritoneal metastases [10].
This study uses gene expression analysis of peritoneal metastases to better understand these neoplasms.
'Hyperdense' renal cysts Pulmonary, nodal, gastric, gallbladder, renal and peritoneal metastases Surgery Chemotherapy IV Suspicious locoregional nodes.
They also found that synchronous peritoneal metastases are associated with a poor prognosis.
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