Psoas/iliacus muscle invasion from mucinous appendiceal neoplasm. Radiologic appearance and outcome of treatment in 3 patients.

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Citation: Surgical Oncology. 27(2):154-157, 2018 Jun.PMID: 29937165Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Abdominal Muscles/pa [Pathology] | *Adenocarcinoma, Mucinous/pa [Pathology] | *Appendiceal Neoplasms/pa [Pathology] | *Chemotherapy, Cancer, Regional Perfusion | *Cytoreduction Surgical Procedures | *Hyperthermia, Induced | *Muscle Neoplasms/pa [Pathology] | *Psoas Muscles/pa [Pathology] | Abdominal Muscles/dg [Diagnostic Imaging] | Adenocarcinoma, Mucinous/dg [Diagnostic Imaging] | Adenocarcinoma, Mucinous/th [Therapy] | Adult | Appendiceal Neoplasms/dg [Diagnostic Imaging] | Appendiceal Neoplasms/th [Therapy] | Biomarkers, Tumor | Chemotherapy, Adjuvant | Combined Modality Therapy | Female | Humans | Male | Middle Aged | Muscle Neoplasms/dg [Diagnostic Imaging] | Muscle Neoplasms/th [Therapy] | Peritoneal Neoplasms/dg [Diagnostic Imaging] | Peritoneal Neoplasms/pa [Pathology] | Peritoneal Neoplasms/th [Therapy] | Prognosis | Prospective Studies | Psoas Muscles/dg [Diagnostic Imaging] | Tomography, X-Ray ComputedYear: 2018ISSN:
  • 0960-7404
Name of journal: Surgical oncologyAbstract: BACKGROUND: Mucinous appendiceal neoplasms have a pattern of metastases that is different from the other gastrointestinal cancers. The first site for cancer dissemination is the peritoneal space surrounding the primary tumor and this is followed by increasingly extensive peritoneal spread. Invasion of the psoas and iliacus muscle is an unusual phenomenon.CONCLUSION: Despite the fact that mucinous tumor invasion was outside the peritoneal cavity, long term benefit from psoas muscle resection with a mucinous appendiceal neoplasm is possible and resection possibly with HIPEC should be considered.Copyright (c) 2018 Elsevier Ltd. All rights reserved.METHOD: From a prospective database of appendiceal mucinous neoplasms treated by cytoreductive surgery (CRS) and perioperative hyperthermic chemotherapy (HIPEC), patients with psoas muscle invasion were reviewed. Their clinical features and treatments were tabulated.RESULTS: Three patients with ages 33, 60, and 63 were identified. Two patients had disease progression into the psoas muscle 33 and 95 months after CRS plus HIPEC. One had dissecting mucinous tumor into psoas, iliacus and quadratus lumborum muscle at the time of diagnosis of the appendiceal mucinous neoplasm. All three survived at least five years from their initial treatment.All authors: Sugarbaker PHFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2018-07-06
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Journal Article MedStar Authors Catalog Article 29937165 Available 29937165

BACKGROUND: Mucinous appendiceal neoplasms have a pattern of metastases that is different from the other gastrointestinal cancers. The first site for cancer dissemination is the peritoneal space surrounding the primary tumor and this is followed by increasingly extensive peritoneal spread. Invasion of the psoas and iliacus muscle is an unusual phenomenon.

CONCLUSION: Despite the fact that mucinous tumor invasion was outside the peritoneal cavity, long term benefit from psoas muscle resection with a mucinous appendiceal neoplasm is possible and resection possibly with HIPEC should be considered.

Copyright (c) 2018 Elsevier Ltd. All rights reserved.

METHOD: From a prospective database of appendiceal mucinous neoplasms treated by cytoreductive surgery (CRS) and perioperative hyperthermic chemotherapy (HIPEC), patients with psoas muscle invasion were reviewed. Their clinical features and treatments were tabulated.

RESULTS: Three patients with ages 33, 60, and 63 were identified. Two patients had disease progression into the psoas muscle 33 and 95 months after CRS plus HIPEC. One had dissecting mucinous tumor into psoas, iliacus and quadratus lumborum muscle at the time of diagnosis of the appendiceal mucinous neoplasm. All three survived at least five years from their initial treatment.

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