Peritoneal Surface Malignancies

Abstract

The term Peritoneal Surface Malignancies (PSMs) identifies a wide range of epithelial or mesenchymal neoplasms that originate from the primitive structure of the peritoneum or spread over and through the peritoneum membrane as metastases deriving from tumors of intra-abdominal, retroperitoneal, or extraabdominal organs or viscera (Table 1.1). PSM evolution depends on the degree of aggressiveness of the various neoplastic forms: in contrast with benign or low malignant forms, aggressive forms are able to produce fast and fatal disease progression. The primitive forms are much rarer than secondary forms, and mesotheliomas and serous tumors of the peritoneum are the most common among them. Colorectal, gastric, and ovarian peritoneal carcinomatosis (PC) are the most frequent forms of PSM arising from intraperitoneal viscera. PSMs originating from retroperitoneal tumors, such as the pancreas, kidneys, or adrenals, are rare and even less frequent are those originating from extra-abdominal tumors, such as breast or lung cancer. Epithelial forms are far more frequent than mesenchymal forms. Primary tumors of the peritoneum and carcinomatosis from gynecological or gastrointestinal tumors are overall the most widespread and common PSMs treated in surgery and oncology. Irrespective of histological differences, most PSMs have a common tendency to grow for a relatively long period of time exclusively in the abdominal cavity, thus representing an ideal target for aggressive locoregional treatments.