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Intraperitoneal Spread of Malignancies

  • Chapter
Dynamic Radiology of the Abdomen

Abstract

The spread of neoplasms within the peritoneal cavity occurs by direct invasion, intraperitoneal seeding, embolic metastases, and lymphatic extension.1,2 Recent insights and basic correlation with the pathogenesis of the intraabdominal spread of malignancies have established that the pattern of involvement and the individual effects of secondary malignancies of the bowel often present characteristic radiologic features.13–6 These reflect the mode of dissemination and thereby indicate the primary site. They are based on the application of certain gross anatomic relationships, the dynamic factors of the flow of ascites, and conditions of hematogenous dissemination.

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References

  1. Meyers MA, McSweeney J: Secondary neoplasms of the bowel. Radiology 105: 1–11, 1972

    CAS  PubMed  Google Scholar 

  2. Willis RA: The Spread of Tumours in the Human Body. Second edition. Butterworth and Co, London, 1952

    Google Scholar 

  3. Meyers MA: Distribution of intra—abdominal malignant seeding: Dependency on dynamics of flow of ascitic fluid. AJR 119: 198–206, 1973

    CAS  Google Scholar 

  4. Meyers MA: Metastatic seeding along small bowel mesentery: Roentgen features. AJR 123: 67–73, 1975

    CAS  Google Scholar 

  5. Meyers MA: Intraperitoneal spread of malignancies and its effect on the bowel. Second Annual Leeds Lecture. Clin Radiol 32: 129–146, 1981

    CAS  PubMed  Google Scholar 

  6. Meyers MA, Whalen JP: Roentgen significance of the duodenocolic relationships: An anatomic approach. AJR 117: 263–274, 1973

    CAS  Google Scholar 

  7. De Castro CA, Dockerty MB, Mayo CW: Metastatic tumors of the small intestines. Int Abstr Surg 105: 159–165, 1957

    Google Scholar 

  8. Farmer RG, Hawk WA: Metastatic tumors of the small bowel. Gastroenterology 47: 496–504, 1964

    CAS  PubMed  Google Scholar 

  9. Meyers MA, Oliphant M, Berne AS, et al: The peritoneal ligaments and mesenteries: Pathways of intra—abdominal spread of disease. Annual Oration. Radiology. 163: 593–604, 1987

    CAS  PubMed  Google Scholar 

  10. Oliphant M, Berne A, Meyers MA: Subperitoneal spread of intraabdominal disease. In Computed Tomography of the Gastrointestinal Tract Including the Peritoneal Cavity and Mesentery. Edited by MA Meyers. SpringerVerlag, New York, 1986, pp 95–137

    Google Scholar 

  11. Oliphant M, Berne AS: Computed tomography of the subperitoneal space: Demonstration of direct spread of intraabdominal disease. J Comp Assist Tomogr 6(6): 1127–1137, 1982

    CAS  Google Scholar 

  12. Balfe DM, Mauro MA, Koehler RE, et al: Gastrohepatic ligament: Normal and pathologic CT anatomy. Radiology 150: 485–490, 1984

    CAS  PubMed  Google Scholar 

  13. Weinstein JB, Heiken JP, Lee JKT, et al: High resolution CT of the porta hepatis and hepatoduodenal ligament. Radiographics 6(1): 55–73, 1986

    CAS  PubMed  Google Scholar 

  14. Dehn CB, Reznek RH, Nockler B, et al: The preoperative assessment of advanced gastric cancer by computed tomography. Br J Surg 71: 413–417, 1984

    CAS  PubMed  Google Scholar 

  15. Vaittinen F: Carcinoma of the gallbladder: A study of 390 cases diagnosed in Finland 1953–1967. Ann Chir Gynecol Fenn 29(Suppl 168): 7, 1970

    Google Scholar 

  16. Meyers MA, Volberg F, Katzen B, et al: Haustral anatomy and pathology: A new look. I. Roentgen identification of normal pattern and relationships. Radiology 108: 497–504, 1973

    CAS  PubMed  Google Scholar 

  17. Meyers MA, Volberg F, Katzen B, et al: Haustral anatomy and pathology: A new look. II. Roentgen interpretation of pathologic alterations. Radiology 108: 505–512, 1973

    CAS  PubMed  Google Scholar 

  18. Kajitan T, Kyuno K, Nishi M: Pathology of gastric cancer. Gendaig 35B: 19–81. Nakayamashoten, Tokyo, 1974

    Google Scholar 

  19. Meyers MA, Oliphant M, Teixidor H, et al: Metastatic carcinoma simulating inflammatory colitis. AJR 123: 67–83, 1975

    CAS  Google Scholar 

  20. Rubesin SE, Levine MS: Omental cakes: Colonic involvement by omental metastases. Radiology 154: 593–596, 1985

    CAS  PubMed  Google Scholar 

  21. Rubesin SE, Levine MS, Glick SN: Gastric involvement by omental cakes: Radiographic findings. Gastrointest Radiol 11: 223–228, 1986

    CAS  PubMed  Google Scholar 

  22. Meyers MA: Roentgen significance of the phrenicocolic ligament. Radiology 95: 539–545, 1970

    CAS  PubMed  Google Scholar 

  23. Bachman AL: Roentgen appearance of gastric invasion from carcinoma of the colon. Radiology 63: 814–822, 1954

    CAS  PubMed  Google Scholar 

  24. Lee KR, Levine E, Moffat RE, et al: Computed tomographic staging of malignant gastric neoplasms. Radiology 133: 151–155, 1979

    CAS  PubMed  Google Scholar 

  25. Moss AA, Schnyder P, Marks W, et al: Gastric adenocarcinoma: A comparison of the accuracy and economics of staging by computed tomography and surgery. Gastroenterology 80: 45–50, 1981

    CAS  PubMed  Google Scholar 

  26. Kiyota YK, Mukai H, et al: Endoscopic ultrasonography (EUS) in the diagnosis of upper digestive tract diseases. Determination of the depth of cancer invasion. Gastroenterol Endosc 28: 253–263, 1986

    Google Scholar 

  27. Komaki S: Gastric carcinoma. In Computed Tomography of the Gastrointestinal Tract: Including the Peritoneal Cavity and Mesentery. Edited by MA Meyers. Springer-Verlag, New York, Tokyo, 1986, pp 23–54

    Google Scholar 

  28. Machi J, Takeda J, Sigel B, et al: Normal stomach wall and gastric cancer: Evaluation with high—resolution operative US. Radiology 159: 85–87, 1986

    CAS  PubMed  Google Scholar 

  29. Meyers MA, Evans JA: Effects of pancreatitis on the small bowel and colon: Spread along mesenteric planes. AJR 119: 151–165, 1973

    CAS  Google Scholar 

  30. Treitel H, Meyers MA, Maza V: Changes in the duodenal loop secondary to carcinoma of the hepatic flexure of the colon. Br J Radiol 43: 209–213, 1970

    CAS  PubMed  Google Scholar 

  31. Krestin GP, Beyer D, Lorenz R: Secondary involvement of the transverse colon by tumors of the pelvis: Spread of malignancies along the greater omentum. Gastrointest Radiol 10: 283–288, 1985

    CAS  PubMed  Google Scholar 

  32. Vieta JO, Blanco R, Valentini GR: Malignant duodenocolic fistula: Report of two cases, each with one or more synchronous gastrointestinal cancers. Dis Colon Rectum 19: 542–552, 1976

    CAS  PubMed  Google Scholar 

  33. Diamond RT, Greenberg HM, Boult IF: Direct metastatic spread of right colonic adenocarcinoma to duodenum: Barium and computed tomographic findings. Gastrointest Radiol 6: 339–341, 1981

    CAS  PubMed  Google Scholar 

  34. McCort JJ: Roentgenographic appearance of metastases to central lymph nodes of superior mesenteric artery in carcinoma of right colon. Radiology 60: 641–646, 1953

    CAS  PubMed  Google Scholar 

  35. Schabel SI, Rogers CI, Rittenberg GM: Duodeno—duodenal fistula—A manifestation of carcinoma of the colon. Gastrointest Radiol 3: 15–17, 1978

    CAS  PubMed  Google Scholar 

  36. Jeffrey RB, Federle MP, Goodman PC: Computed tomography of the lesser peritoneal sac. AJR 144: 567–575, 1985

    Google Scholar 

  37. Jeffrey RB, Federle MP, Goodman PC: Computed tomography of the lesser peritoneal sac. AJR 144: 567–575, 1985

    Google Scholar 

  38. Dodds WJ, Foley WD, Lawson TL, et al: Pictorial Essay. Anatomy and Imaging of the Lesser Peritoneal Sac. AJR 144: 567–575, 1985

    CAS  PubMed  Google Scholar 

  39. Chun CH, Raff MF, Conteras L, et al: Splenic abscess. Medicine (Baltimore) 59: 50–65, 1980

    CAS  Google Scholar 

  40. Meyers MA: Peritoneography: Normal and pathologic anatomy. AJR 117: 353–365, 1973

    CAS  Google Scholar 

  41. Meyers MA: Clinical involvement of mesenteric and anti—mesenteric borders of small bowel. I. Normal pattern and relationships. Gastrointest Radiol 1(1): 41–48, 1976

    CAS  PubMed  Google Scholar 

  42. Meyers MA: Clinical involvement of mesenteric and anti—mesenteric borders of small bowel. II. Radiologic interpretation of pathologic alterations. Gastrointest Radiol 1(1): 49–58, 1976

    CAS  PubMed  Google Scholar 

  43. Whitley NO, Bohlman ME, Baker LP: CT patterns of mesenteric disease. J Comp Assist Tomogr 6(3): 490–496, 1982

    CAS  Google Scholar 

  44. Whitley NO: Mesenteric disease. In Computed Tomography of the Gastrointestinal Tract Including the Peritoneal Cavity and Mesentery. Edited by MA Meyers. Springer—Verlag, New York, 1986, pp 139–178

    Google Scholar 

  45. Mueller PR, Ferrucci JT, Harbin WP, et al: Appearance of lymphomatous involvement of the mesentery by ultrasonography and body computed tomography: The “sandwich sign.” Radiology 134: 467–473, 1980

    CAS  PubMed  Google Scholar 

  46. Grinnel RS: Lymphatic block with atypical and retrograde lymphatic metastasis and spread in carcinoma of the colon and rectum. Ann Surg 163: 272–280, 1966

    Google Scholar 

  47. Moffat RE, Gourley WK: Ileal lymphatic metastases from cecal carcinoma. Radiology 135: 55–58, 1980

    CAS  PubMed  Google Scholar 

  48. Perez C, Cacares J, Valls J: Carcinoma of the hepatic flexure with proximal lymphatic invasion mimicking Crohn’s disease. Gastrointest Radiol 9: 365–367, 1984

    CAS  PubMed  Google Scholar 

  49. Threefoot SA: Gross and microscopic anatomy of the lymphatic vessels and lymphaticovenous communications. Cancer Chemother Rep 52: 1–20, 1968

    CAS  PubMed  Google Scholar 

  50. Pressman J, Dunn RF, Burtz M: Lymph node ultrastructure related to direct lymphaticovenous communication. Surg Gynecol Obstet 124: 963–973, 1967

    CAS  PubMed  Google Scholar 

  51. Correia JP, Baptista AS, Antonio JF: Slowly evolving widespread diffuse alimentary tract carcinoma (linitis plastica). Gut 9: 485–488, 1968

    PubMed Central  CAS  PubMed  Google Scholar 

  52. Khilnani MT, Marshak RH, Eliasoph J, et al: Roentgen features of metastases to the colon. AJR 96: 302–310, 1966

    CAS  Google Scholar 

  53. Wigh R, Tapley Ndu V: Metastatic lesions to the large intestine. Radiology 70: 222–228, 1958

    CAS  PubMed  Google Scholar 

  54. Gengler L, Baer J, Finby N: Rectal and sigmoid involvement secondary to carcinoma of the prostate. AJR 125: 910–917, 1975

    CAS  Google Scholar 

  55. Winter CC: The problem of rectal involvement by prostatic cancer. Surg Gynecol Obstet 105: 136–140, 1957

    CAS  PubMed  Google Scholar 

  56. Young HH: The cure of cancer of the prostate by radical perineal prostatectomy (prostato—semiinal vesiculectomy). History, literature, and statistics of Young’s operation. J Urol 53: 188–252, 1945

    Google Scholar 

  57. Kradjian RM, Bennington JL: Renal carcinoma recurrent 31 years after nephrectomy. Arch Surg 90: 192–195, 1965

    CAS  PubMed  Google Scholar 

  58. Khilnani MT, Wolf BS: Late involvement of the alimentary tract by carcinoma of the kidney. Am J Dig Dis 5: 529–540, 1960

    CAS  PubMed  Google Scholar 

  59. Shoemaker CP, Hoyle CL, Levine SB, et al: Late solitary recurrence of renal carcinoma. Am J Surg 120: 99–100, 1970

    PubMed  Google Scholar 

  60. Meyers MA: The spread and localization of acute intraperitoneal effusions. Radiology 95: 547–554, 1970

    CAS  PubMed  Google Scholar 

  61. Sampson JA: Implantation peritoneal carcinomatosis of ovarian origin. Am J Pathol 7: 423–443, 1931

    PubMed Central  CAS  PubMed  Google Scholar 

  62. Buie LA, Jackman RJ, Vickers PM: Extrarectal masses caused by tumors of the recto—uterine or rectovesical space. JAMA 117: 167–169, 1941

    Google Scholar 

  63. Raiford TS: Tumors of small intestine. Arch Surg 25: 321–355, 1932

    Google Scholar 

  64. Walther HE: Krebsmetastasen, Benno Schwabe, Basel, 1948

    Google Scholar 

  65. Hultborn KA, Morales O, Romanus R: The socalled shelf tumour of the rectum. Acta Radiol Suppl 124: 1955

    Google Scholar 

  66. Theander G, Wehlin L, Langeland P: Deformation of the rectosigmoid junction in peritoneal carcinomatosis. Acta Radiol Diagn 1: 1071–1076, 1963

    CAS  Google Scholar 

  67. Blumer G: Rectal shelf: Neglected rectal sign of value in diagnosis of obscure malignant and inflammatory disease within abdomen. Albany Med Ann 30: 361, 1909

    Google Scholar 

  68. Esenstein ML, Shaw SL, Pak HY, et al: CT demonstration of multiple intraperitoneal teratomatous implants. J Comp Assist Tomogr 7: 1117–1118, 1983

    Google Scholar 

  69. Feldman GB, Knapp RC: Lymphatic drainage of the peritoneal cavity and its significance in ovarian cancer. Am J Obstet Gynecol 119: 991–994, 1974

    CAS  PubMed  Google Scholar 

  70. Simer PH: The drainage of particulate matter from the peritoneal cavity by lymphatics. Anat Rec 88: 175–192, 1944

    Google Scholar 

  71. Feldman GB, Knapp RC, Order SE: The role of lymphatic obstruction in the formation of ascites in a murine ovarian carcinoma. Cancer Res 32: 1663–1666, 1972

    CAS  PubMed  Google Scholar 

  72. Higgins GM, Graham AS: Lymphatic drainage from the peritoneal cavity in the dog. Arch Surg 19: 453–465, 1929

    Google Scholar 

  73. Bettendorf U: Lymph flow mechanism of the subperitoneal diaphragmatic lymphatics. Lymphology 11: 111–116, 1978

    CAS  PubMed  Google Scholar 

  74. French GE, Florey HW, Morris BL: The absorption of particles by the lymphatics of the diaphragm. Q J Exp Biol 45: 88–103, 1960

    CAS  Google Scholar 

  75. Vock P, Hodler J: Cardiophrenic angle adenopathy: Update of causes and significance. Radiology 159: 395–399, 1986

    CAS  PubMed  Google Scholar 

  76. Bergman F: Carcinoma of the ovary: A clinicopathological study of 86 autopsied cases with special reference to mode of spread. Acta Obstet Gynecol Scand 45: 211–231, 1966

    CAS  PubMed  Google Scholar 

  77. Rosenoff SH, DeVita VT, Hubbard S, et al: Peritoneoscopy in staging and follow—up of ovarian cancer. Semin Oncol 2(3): 223–228, 1975

    CAS  PubMed  Google Scholar 

  78. Dagnini G, Marin G, Caldironi MW, et al: Laparoscopy in staging, follow—up, and restaging of ovarian carcinoma. Gastrointest Endosc 33: 80–83, 1987

    CAS  PubMed  Google Scholar 

  79. Ozols RF, Fisher RI, Anderson T, et al: Peritoneoscopy in the management of ovarian cancer. Am J Obstet Gynecol 140: 611–619, 1981

    CAS  PubMed  Google Scholar 

  80. Piver MS, Barlow JJ, Lele SB: Incidence of subclinical metastasis in stage I and II ovarian carcinoma. Obstet Gynecol 52: 100–104, 1978

    CAS  PubMed  Google Scholar 

  81. Young RC, Decker DG, Wharton JT, et al: Staging laparotomy in early ovarian cancer. JAMA 250(22): 3072–3076, 1983

    CAS  PubMed  Google Scholar 

  82. Triller J, Goldnirsch A, Reinhard J-P: Subcapsular liver metastasis in ovarian cancer: Computed tomography and surgical staging. Europ J Radiol 5: 261–266, 1985

    CAS  Google Scholar 

  83. Jeffrey RB Jr: CT demonstration of peritoneal implants. Am J Roentgenol 135: 323–326, 1980

    Google Scholar 

  84. Kalovidouris A, Gouliamos A, Pontifex GR, et al: Computed tomography of ovarian carcinoma. Acta Radiol Diagn 25: 203–208, 1984

    CAS  Google Scholar 

  85. Seshul MB, Coulam CM: Pseudomyxoma peritonei: Computed tomography and sonography. AJR 136: 803–806, 1981

    CAS  PubMed  Google Scholar 

  86. Miller DL, Udelsman R, Sugarbaker PH: Case report: Calcification of pseudomyxoma peritonei following intraperitoneal chemotherapy: CT demonstration. J Comp Assist Tomogr 9: 1123–1124, 1985

    CAS  Google Scholar 

  87. Mitchell DG, Hill MC, Hill S, et al: Serous carcinoma of the ovary: CT identification of metastatic calcified implants. Radiology 158: 649–652, 1986

    CAS  PubMed  Google Scholar 

  88. Pandolfo I, Blandino A, Gaeta M, et al: Calcified peritoneal metastases from papillary cystadeno—carcinoma of the ovary: CT features. J Comp Assist Tomogr 10(3): 545–546, 1986

    CAS  Google Scholar 

  89. Solomon A, Rubinstein Z: Importance of the falciform ligament, ligamentum teres, and splenic hilus in the spread of malignancy as demonstrated by computed tomography. Gastrointest Radiol 9: 53–56, 1984

    CAS  PubMed  Google Scholar 

  90. Ferenczy A, Talens M, Zoghby M, et al: Ultrastructural studies on the morphogenesis of psammoma bodies in ovarian serous neoplasia. Cancer 39: 2451–2459, 1977

    CAS  PubMed  Google Scholar 

  91. Cooper C, Jeffrey RB, Silverman PM, et al: Computed tomography of omental pathology. J Comp Assist Tomogr 10(1): 62–66, 1986

    CAS  Google Scholar 

  92. Levitt RG, Sagel SS, Stanley RJ: Detection of neoplastic involvement of the mesentery and omentum by computed tomography. AJR 131: 835–838, 1978

    CAS  PubMed  Google Scholar 

  93. Meyers MA: Clinical report: A new view of the peritoneal cavity. Mod Med 44(6): 51–56, 1976

    Google Scholar 

  94. Dunnick NR, Jones RB, Doppman JL, et al: Intraperitoneal contrast infusion for assessment of intraperitoneal fluid dynamics. AJR 133: 221–223, 1979

    CAS  PubMed  Google Scholar 

  95. Meyers MA: Peritoneography: Normal and pathologic anatomy. Chapter 3 in Dynamic Radiology of the Abdomen: Normal and Pathologic Anatomy. Springer—Verlag, New York, 1976.

    Google Scholar 

  96. Roub LW, Drayer BP, Orr DP, et al: Computed tomographic positive contrast peritoneography. Radiology 131: 699–704, 1979

    CAS  PubMed  Google Scholar 

  97. Asch MJ, Wiedel PD, Habif DV: Gastrointestinal metastases from carcinoma of the breast: Autopsy study and 18 cases requiring operative intervention. Arch Surg 96: 840–843, 1968

    CAS  PubMed  Google Scholar 

  98. Graham WP III: Gastrointestinal metastases from carcinoma of the breast. Ann Surg 159: 477–480, 1964

    PubMed Central  PubMed  Google Scholar 

  99. Oddson TA, Rice RP, Seiler HF, et al: The spectrum of small bowel melanoma. Gastrointest Radiol 3: 419–423, 1978

    CAS  PubMed  Google Scholar 

  100. Goldstein HM, Beydoun MT, Dodd GD: Radiologic spectrum of melanoma metastatic to the gastrointestinal tract. AJR 129: 605–612, 1977

    CAS  PubMed  Google Scholar 

  101. Smith SJ, Carlson HC, Gisvold JJ: Secondary neoplasms of the small bowel. Radiology 125: 29–33, 1977

    CAS  PubMed  Google Scholar 

  102. Das Gupta T, Brasfield R: Metastatic melanoma: Clinico—pathologic study, Cancer 17: 1323–1339, 1969

    Google Scholar 

  103. Coman DR, De Long KP, McCutcheon M: Studies on the mechanism of metastasis: The distribution of tumors in various organs in relation to the distribution of arterial emboli. Cancer Res 11: 648–651, 1951

    CAS  PubMed  Google Scholar 

  104. Einhorn LH, Burgess MA, Vallejos C, et al: Prognostic correlations and response to treatment in advanced metastatic malignant melanoma. Cancer Res 34: 1995–2004, 1974

    CAS  PubMed  Google Scholar 

  105. Choi SH, Sheehan FR, Pickren JW: Metastatic involvement of the stomach by breast cancer. Cancer 17: 791–797, 1964

    CAS  PubMed  Google Scholar 

  106. Eker R, Efskind J: Investigations on the intramural spread of gastric carcinoma. Acta Path Microbiol Scand 30: 371–383, 1952

    CAS  PubMed  Google Scholar 

  107. Cormier JC, Gaffey TA, Welch JM, et al: Linitis plastica caused by metastatic lobular carcinoma of the breast. Mayo Clin Proc 55: 747–753, 1980

    CAS  PubMed  Google Scholar 

  108. Joffe N: Metastatic involvement of the stomach secondary to breast carcinoma. AJR 123: 512–521, 1975

    CAS  Google Scholar 

  109. Antler AS, Ough Y, Pitchumoni CS, et al: Gastrointestinal metastases from malignant tumors of the lung. Cancer 49: 170–172, 1982

    CAS  PubMed  Google Scholar 

  110. Luomanen RKJ, Watson WL: Autopsy findings. Lung Cancer: A Study of Five Thousand Memorial Hospital Cases, Chapter 20. Edited by WL Watson. CV Mosby, St. Louis, Mo. 1968

    Google Scholar 

  111. Smith HJ, Vlasak MG: Metastasis to the colon from bronchogenic carcinoma. Gastrointest Radiol 2: 393–396, 1977

    Google Scholar 

  112. Hayes HT, Burr HB: Hypernephroma of the sigmoid colon. Am J Surg 81: 98–100, 1951

    CAS  PubMed  Google Scholar 

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Meyers, M.A. (1988). Intraperitoneal Spread of Malignancies. In: Dynamic Radiology of the Abdomen. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3961-9_4

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  • DOI: https://doi.org/10.1007/978-1-4757-3961-9_4

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