Peritoneal tunnels: A site at risk for treatment failure when performing treatments for peritoneal metastases. A case series of 2 patients. 

 -  2019 
<br/><br/> BACKGROUND: Peritoneal metastases from gastrointestinal cancer can be treated by a combination of surgery to remove visible evidence of disease and perioperative intraperitoneal chemotherapy to eradicate microscopic disease. Complete cytoreduction is necessary for long-term benefit.  CONCLUSIONS: Peritoneal tunnels in the inguinal region or at the porta hepatis should be opened by surgical dissection so that all foci of peritoneal metastases are removed at a complete cytoreductive surgery and these sites treated with chemotherapy.  Copyright (c) 2019. Published by Elsevier Ltd.  METHODS: Two sites for incomplete cytoreduction because tumor is hidden from visual inspection were identified. Patients who developed recurrence at these anatomic sites were studied.  RESULTS: A peritoneal tunnel along a patent processus vaginalis allowed tumor to be sequestered along the inguinal canal in a female patient. A peritoneal tunnel beneath a hepatic bridge over the round ligament obscured mucinous tumor in a male patient. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>2210-2612 
<br/><br/><label>Standard No.: </label>10.1016/j.ijscr.2019.07.026 [doi] S2210-2612(19)30408-0 [pii] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>IN PROCESS -- NOT YET INDEXED
<br/><br/><label>Subjects--Geographic Terms: </label><br/>Washington Cancer Institute
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article