Intraluminal primary extra-ovarian peritoneal serous papillary carcinoma: A case report and literature review

doi:10.3969/j.issn.1004-583X.2025.03.011

Abstract

Abstract:

Objective To examine a rare case of extra-ovarian peritoneal serous papillary carcinoma (EPSPC) with an atypical growth pattern and to evaluate its clinical and pathological features and diagnostic approach. Methods A middle-aged female patient with EPSPC was retrospectively analyzed, and relevant literature was reviewed. Results The patient presented with abdominal pain and altered bowel habits for two months. Colonoscopy and magnetic resonance imaging (MRI) revealed a large rectal mass and a rectal cystic lesion, respectively. Exploratory laparotomy showed tumor involvement of the rectal left anterior wall mucosa, and the cystic wall suggested malignancy. Histopathology excluded ovarian and uterine origins. Laparoscopic radical resection of rectal cancer was performed, and EPSPC was diagnosed. Conclusion EPSPC has a high clinical misdiagnosis rate, especially intraluminal EPSPC, which mimics primary intestinal adenocarcinoma. Diagnosis relies on clinical and pathological features. Compared to ovarian serous carcinoma, EPSPC has a poorer prognosis, with surgery and chemotherapy as the main treatment options.

Key words: peritoneal neoplasms, peritoneal serous papillary carcinoma, differential diagnosis, case report

CLC Number:

R735.5

Li Zhongbiao, Zhao Xihao, Du Min, Wang Jiang, Yu Yue, Zhang Dianliang. Intraluminal primary extra-ovarian peritoneal serous papillary carcinoma: A case report and literature review[J]. Clinical Focus, 2025, 40(3): 257-261.

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URL: https://lchc.magtechjournal.com/EN/10.3969/j.issn.1004-583X.2025.03.011

https://lchc.magtechjournal.com/EN/Y2025/V40/I3/257

Figures/Tables 3

Fig.1 Tumor-related imaging findings a, b. Pelvic contrast-enhanced CT shows multiple uterine nodules (blue markers) and a thick-walled cystic lesion (red marker) posterior to the uterus compressing the adjacent rectum with localized bowel wall thickening; c, d. Pelvic MR enhancement reveals an ovoid T1 signal in the upper rectum; e.Colonoscopy identifies a large protruding lesion narrowing the lumen by approximately 50%; f.Intraoperative findings reveal the tumor (red marker) primarily below the peritoneal reflection, located between the rectum (green marker) and uterus (blue marker), with bilaterally normal-appearing ovaries (black markers).

Fig.2 Tumor related pathological findings H&E Staining: a. Tumor predominantly located in the serosa, invading the muscular and submucosal layers; yellow arrow: serosa, red arrow: muscular layer (×20); b.tumor cells micropapillary pattern with pleomorphic nuclei and mitoses (×40). Immunohistochemistry staining (×50):c. WT-1 nuclear positivity;d.P53 diffuse nuclear staining with an 80% missense mutation rate;e.ER scattered nuclear positivity; f. CK-7 diffuse membrane and cytoplasmic positivity; g. PAX-8 positive; (H) CDX-2 negative.

Fig.3 Immunohistochemistry staining (×50): neuroendocrine marker SYN positive.

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