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Atypical Cells in Peritoneal Cleft: A Pitfall in Diagnosis of Colorectal Adenocarcinoma. Int J Surg Pathol 2021 Aug;29(5):506-509

Date

01/19/2021

Pubmed ID

33455512

DOI

10.1177/1066896920988346

Scopus ID

2-s2.0-85100106764

Abstract

Atypical cells in peritoneal clefts are usually either reactive mesothelial cells or pT4 colonic adenocarcinoma in colon specimen removed for primary colon cancer. However, rarely if ever are these atypical cells metastasis from other primary visceral malignancy due to "sac-like" anatomic structure of this area. We present a case where these atypical cells were determined to be metastasis of gynecological origin by judicious use of immunohistochemical stains. A final diagnosis of serous tubal intraepithelial carcinoma of right fallopian tube was diagnosed only after total abdominal hysterectomy bilateral salpingo-oophorectomy. To our knowledge, this is the first report of a serous tubal intraepithelial carcinoma presenting as stage 4 colonic adenocarcinoma. The importance of this interesting case is 2-fold. It highlights the peritoneal cleft as an anatomic region not often recognized or discussed as well as tumor presentation in this region. In addition, this example stresses the need for additional mesothelial markers in addition to WT-1 workup of atypical mesothelial proliferation.

Author List

Lee W, Chandan VS, Johnson C, Li X

Author

Whayoung Lee MD Assistant Professor in the Pathology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Colorectal Neoplasms
Cystadenocarcinoma, Serous
Diagnosis, Differential
Fallopian Tube Neoplasms
Fallopian Tubes
Female
Humans
Hysterectomy
Incidental Findings
Middle Aged
Peritoneal Neoplasms
Peritoneum
Salpingo-oophorectomy