"Mom778082" Your ltr Re Pseudomyxoma peritonei (PMP) ~ References here may help others N time 2 come ~Wishing U all the best! :)

Dear Mom ~

You have written a post on an inactive forum topic so I've elected to place my answer to you here.  You wrote:  https://csn.cancer.org/comment/1628097#comment-1628097 10:36 on May 11^th PMP "I was diagnosed with PMP in 1983. I'm trying to find out if anyone has heard of this spreading to the kidney. I have a large complex cyst on my right kidney."

You also wrote another short note on that same forum stating that you had PMP and had been in remission for 35 years, so I will begin my remarks here:)

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Dear Mom ~

In remission 35 years later from is fantastic.  Pseudomyxoma peritonei (PMP) is a malignant condition in the appendix characterized by mucinous ascites and peritoneal, mucinous implantations.

In regard to your question about possibility of spread to the kidney, I haven’t a clue.  However, I looked up some references and I have included them here.  The only thing I do know for sure is that if this were me, I would want to have any and all of the tests necessary to know exactly what needs to be done for the complex cyst on your right kidney NOW.  In the first reference below, a number of tests are listed to find out exactly what is going on and I hope you have found a specialist that is conducting these tests to determine your particular problem. 

I wish I could be of more help, but hopefully the references below might be useful to you in some way as well as others who may receive this same diagnosis in the future.  Hoping that all your problems can be resolved without metastasis to any other organ.

Loretta (Peritoneal Carcinomatosis/Ovarian Cancer Stage IV) DX November of 2012 and blessed to still be alive and in relatively good condition considering all the things we experience with such a diagnosis.

P.S.  There is one suggestion I might make.  If you return in the future with more questions, placing your post on a “separate topic forum” of your very own would keep us from reading through inactive postings to find you and possibly help you.    You’ve answered on a post that is no longer active with the exception of “Abrub” who is quite knowledgeable on this cancer.  All the rest of the people listed here have not posted anything since 2013.  That way we can “find you more easily.” 

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1.     https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032530/#CDR0000343585__15

“Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment (PDQ®)

Patient Version - PDQ Adult Treatment Editorial Board. - Published online: April 30, 2018. - Created: February 20, 2004.

This PDQ cancer information summary has current information about the treatment of transitional cell cancer of the renal pelvis and ureter. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board…

Tests that examine the abdomen and kidneys are used to detect (find) and diagnose transitional cell cancer of the renal pelvis and ureter.

The following tests and procedures may be used:

1. Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
2. Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, blood, and bacteria.
3. Ureteroscopy: A procedure to look inside the ureter and renal pelvis to check for abnormal areas. A ureteroscope is a thin, tube-like instrument with a light and a lens for viewing. The ureteroscope is inserted through the urethra into the bladder, ureter, and renal pelvis. A tool may be inserted through the ureteroscope to take tissue samples to be checked under a microscope for signs of disease.
4. Ureteroscopy. A ureteroscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the urethra into the ureter. The doctor looks at an image of the inside of the ureter on a computer monitor.
5. Urine cytology: A laboratory test in which a sample of urine is checked under a microscope for abnormal cells. Cancer in the kidney, bladder, or ureter may shed cancer cells into the urine.
6. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
7. Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An ultrasound of the abdomen may be done to help diagnose cancer of the renal pelvis and ureter.
8. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the pelvis. This procedure is also called nuclear magnetic resonance imaging (NMRI).
9. Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. This may be done during a ureteroscopy or surgery…”

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2.     https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032530/

PDQ Cancer Information Summaries [Internet].

Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment (PDQ®)

Patient Version

PDQ Adult Treatment Editorial Board. - Published online: April 30, 2018. - Created: February 20, 2004.

This PDQ cancer information summary has current information about the treatment of transitional cell cancer of the renal pelvis and ureter. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

Key Points for This Section

• Transitional cell cancer of the renal pelvis and ureter is a disease in which malignant (cancer) cells form in the renal pelvis and ureter.
• A personal history of bladder cancer and smoking can affect the risk of transitional cell cancer of the renal pelvis and ureter.
• Signs and symptoms of transitional cell cancer of the renal pelvis and ureter include blood in the urine and back pain.
• Tests that examine the abdomen and kidneys are used to detect (find) and diagnose transitional cell cancer of the renal pelvis and ureter.
• Certain factors affect prognosis (chance of recovery) and treatment options...”

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3.     https://www.ncbi.nlm.nih.gov/pubmed/20592611

"Curr Opin Urol. 2010 Sep;20(5):349-54. doi: 10.1097/MOU.0b013e32833c7b04.

The diagnosis and management of complex renal cysts. = McGuire BB¹, Fitzpatrick JM. - Author information

Abstract - PURPOSE OF REVIEW:

 Cystic renal disease is very common and the detection of complex cystic masses in the kidney has increased dramatically over the last few decades with increased cross-sectional imaging. Cystic renal cell carcinoma represents 5-7% of all renal tumours. The ability to differentiate between those who are benign from those malignant represents a major challenge. The controversy and difficulty lies in those complex cystic renal masses that lie between Bosniak II and III. This review focuses on the diagnosis and management of complex renal cysts, examining the evidence for biopsy and looks at novel diagnostic techniques.

RECENT FINDINGS:

There are varying results in interpretation of complex cysts and this is heavily dependent on interobserver variability. Bosniak classification is a valuable tool for the clinician. Computed tomography remains the gold standard, however, newer diagnostic imaging modalities such as contrast-enhanced ultrasonography is demonstrating promising results. Percutaneous biopsy of these complex lesions would appear to be well tolerated and adequate for diagnosis.

SUMMARY:

The ability to accurately identify complex renal cysts that are malignant remains a major challenge to the clinician. Regularly there is no other way to identify malignant features than to biopsy or continue surveillance. Recent literature would suggest that percutaneous biopsy has a good yield and is accurate in the majority of cases. Current apprehension with regard to iatrogenic complications from percutaneous renal biopsy may be exaggerated, as complication rates are higher in patients with intrinsic real disease rather than this cohort of patients. The overlap in diagnosing Bosniak IIf versus III is heavily influenced by interobserver variability and this needs to be a significant factor in making any decision…”

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4.     https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024298/

About the Kidney

 

“About Renal Cell Cancer - Renal cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney.

Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney. There are 2 kidneys, one on each side of the backbone, above the waist. The tiny tubules in the kidneys filter and clean the blood, taking out waste products and making urine. The urine passes from each kidney into the bladder through a long tube called a ureter. The bladder stores the urine until it is passed from the body.

Cancer that starts in the ureters or the renal pelvis (the part of the kidney that collects urine and drains it to the ureters) is different from renal cell cancer. (See the PDQ summary about Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment for more information)... Read more about Renal Cell Cancer…”

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5.     https://medlineplus.gov/kidneycancer.html

Kidney Cancer - Also called: Hypernephroma, Renal cancer

On this page - Basics

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Summary

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys.

Kidney cancer becomes more likely as you age. Risk factors include smoking, having certain genetic conditions, and misusing pain medicines for a long time.

You may have no symptoms at first. They may appear as the cancer grows. See your health care provider if you notice

• Blood in your urine
• A lump in your abdomen
• Weight loss for no reason
• Pain in your side that does not go away
• Loss of appetite

Tests to diagnose kidney cancer include blood, urine, and imaging tests. You may also have a biopsy.

 Treatment depends on your age, your overall health and how advanced the cancer is. It might include surgery, chemotherapy, or radiation, biologic, or targeted therapies. Biologic therapy boosts your body's own ability to fight cancer. Targeted therapy uses substances that attack cancer cells without harming normal cells.

NIH: National Cancer Institute…”

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6.     http://oncolex.org/Peritoneal-cancer

ABOUT CANCER SPREADING IN THE PERITONEUM

Etiology

Histology

Metastatic patterns

Staging

Symptoms

Differential diagnoses

PrognosisReferences  DIAGNOSTICS TREATMENT FOLLOW-UP CARE

Medical editor

Stein Gunnar Larsen MD - Gastroenterological Surgeon-Oslo University Hospital-----Kathleen Schmeler MD-MD Anderson Cancer Center

Recently updated 30.11.2016

Oncolex - cancer encyclopedia › About cancer spreading in the peritoneum

Cancer spreading in the peritoneum

Cancer spreading in the peritoneum, known as peritoneal carcinomatosis or peritoneal metastases, is the general term for spreading of tumor cells in the peritoneum often originating from other organs in the abdominal cavity. Spread may also occur when a tumor grows through an organ reaching the surface of the peritoneum. Free cancer cells can implant into different areas of the peritoneum.

The peritoneum is a thin membrane consisting of two layers:

• a peritoneal layer which lines the abdominal cavity
• a visceral layer which wraps around the internal organs in the intraperitoneal cavity

The narrow space between these two layers is filled with a thin fluid keeping the peritoneum moist to allow the two layers to glide freely.

Double layer of peritoneum is known as mesentery which houses organs. 

The most common point of origin for peritoneal cancer is the appendix and the colon for both males and females, as well as the gynecologic organs in women. 

However, any tumors in the abdominal cavity can cause peritoneal carcinomatosis. Pseudomyxoma peritonei (PMP) is a malignant condition in the appendix characterized by mucinous ascites and peritoneal, mucinous implantations. Mesothelioma is tumor originating from mesothelial cells that lines body cavities. The most common origin is the pleural cavity, but tumor may also originate from the peritoneal cavity.

Incidence\

About 5-8 % of patients with primary colon cancer and 2% of patients with rectal cancer have carcinomatosis at the time of diagnosis. Several patients have peritoneal metastases at the time of recurrence. In about half of patients with peritoneal carcinomatosis, there is also distant metastases, which makes it complicated to cure the disease.

There are about 20 new cases of pseudomyxoma peritonei per year in Norway. (3-4/million/year). Diffuse malignant peritoneal mesothelioma (DMPM) makes up 1/4 of all mesothelioma.

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7.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999154/

Pseudomyxoma peritonei

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8.     https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pseudomyxoma-peritonei

pseudomyxoma peritonei

 listen (SOO-doh-mik-SOH-muh PAYR-ih-TOH-ny)

 A build-up of mucus in the peritoneal cavity. The mucus may come from ruptured ovarian cysts, from the appendix, or from other abdominal tissues. Mucus-secreting cells may attach to the peritoneal lining and continue to secrete mucus.

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9.     https://www.ncbi.nlm.nih.gov/pubmed/25216980

“Recurrence and outcome after complete tumour removal and hyperthermic intraperitoneal chemotherapy in 512 patients with pseudomyxoma peritonei from perforated appendiceal mucinous tumours.

Lord AC¹, Shihab O², Chandrakumaran K², Mohamed F², Cecil TD², Moran BJ².

Author information - Abstract - BACKGROUND:

Pseudomyxoma peritonei (PMP) usually originates from perforated mucinous appendiceal tumours and may present unexpectedly at surgery, or be suspected at cross sectional imaging. The optimal treatment involves macroscopic tumour removal by cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). The 10-year Kaplan-Meier predicted disease-free survival is 61%. Some patients with recurrence are amenable to further CRS and HIPEC.

AIM:

To evaluate the outcomes of re-do surgery in a large single centre series of reoperation for recurrence of peritoneal surface malignancy.

METHOD:

Retrospective analysis of prospective database of 752 patients undergoing CRS for perforated appendiceal tumours analysed. Routine follow up involved annual CT scans and serum tumour marker measurement. The survival and recurrence in the 512/752 (68.1%) who had complete cytoreduction between March 1994 and January 2012 was calculated by Kaplan-Meier univariate analysis.

RESULTS:

Overall 137/512 (26.4%) developed recurrence and of those 35/137 (25.5%) underwent repeat surgery. Complete tumour removal was again achieved in 20/35 (57.1%). There were no postoperative deaths and no significant difference in early postoperative complications and length of stay compared to primary CRS surgery. The 5-year survival in the 375 without recurrence, the 35 who had re-do surgery and the 102 who had recurrence with no surgery was 90.9%, 79.0% and 64.5% respectively.

CONCLUSION:

Approximately one in four patients develops recurrence after complete CRS and HIPEC for PMP of appendiceal origin. Selected patients can undergo salvage surgery with good outcomes.

Copyright © 2014 Elsevier Ltd. All rights reserved.”

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