Overview
Pseudomyxoma peritonei (PMP) is a rare peritoneal malignancy typically originating from a perforated mucinous neoplasm of the appendix, characterized by mucinous ascites and peritoneal implants 2.Diagnosis
Imaging studies (CT/MRI) to identify peritoneal masses and ascites 2.
Cytology analysis of peritoneal fluid to detect mucinous cells 2.
Histopathological examination of appendiceal tissue for mucinous adenocarcinoma 2.
Endoscopic evaluation may be necessary to assess the primary appendiceal lesion 2.Management
Primary cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is considered the standard approach for eligible patients 2.
Conservative management may be considered in palliative settings, including symptomatic relief with corticosteroids, antibiotics, and proton pump inhibitors 1.
NGT retention may be necessary despite symptoms like NGTS if drainage is critical, with careful monitoring for complications 1.Special Populations
Palliative care settings: Individualized management focusing on symptom control, as demonstrated in cases where conservative measures effectively alleviated symptoms 1.
No specific guidelines provided for pregnancy, pediatrics, or elderly populations in the given abstracts [].Key Recommendations
Perform primary cytoreductive surgery followed by HIPEC for eligible patients with PMP (Evidence: Strong 2).
Consider conservative management with symptomatic treatment in palliative care scenarios, especially when surgical intervention is not feasible (Evidence: Moderate 1).
Monitor closely for complications such as nasogastric tube syndrome in patients requiring prolonged NGT use (Evidence: Expert opinion 1).References
1 Suzuki N. Nasogastric Tube Syndrome: A Case Report of Otalgia and Hoarseness in a Palliative Care Setting. Journal of pain and symptom management 2025. link
2 Govaerts K, Lurvink RJ, De Hingh IHJT, Van der Speeten K, Villeneuve L, Kusamura S et al.. Appendiceal tumours and pseudomyxoma peritonei: Literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2021. link