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Case Reports in Pathology
Volume 2013 (2013), Article ID 608016, 3 pages
http://dx.doi.org/10.1155/2013/608016
Case Report

Pseudomyxoma Peritonei Originating from an Intestinal Duplication

1Department of Imaging and Pathology, University Hospitals Leuven, Minderbroedersstraat 12, 3000 Leuven, Belgium
2Department of Surgery, University Hospitals Leuven, Belgium
3Department of Pathology, Jan Yperman Ziekenhuis, Ieper, Belgium

Received 14 June 2013; Accepted 21 July 2013

Academic Editors: T. Hasebe, U. Manne, Y. Nagashima, and M. L. Wu

Copyright © 2013 Julie Lemahieu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Alimentary tract duplications are rare congenital anomalies. They most often become symptomatic in childhood and rarely undergo malignant transformation. Pseudomyxoma peritonei (PMP) is an equally uncommon condition, most frequently originating from a primary appendiceal mucinous neoplasm. We report an extremely unusual case of PMP arising from an intestinal duplication. A 67-year-old woman presented with vague upper abdominal pain, and, unexpectedly, explorative laparoscopy revealed diffuse jelly-like peritoneal implants. The histopathological diagnosis of a low-grade PMP or “disseminated peritoneal adenomucinosis” was made. At that moment, no primary tumor was found. During later surgery, a cystic lesion located in the mesentery of the small bowel could be resected. Histologically, the cyst wall clearly showed the concentric layering of a normal bowel wall. The mucosa, however, displayed a diffuse low-grade villous adenoma. We concluded that this histological picture was most consistent with a small intestinal duplication, containing a low-grade villous adenoma. The adenoma caused a mucocele, which subsequently leaked or ruptured, giving rise to noninvasive mucinous peritoneal implants or low-grade PMP, also known as “disseminated peritoneal adenomucinosis” (DPAM).