Primary Peritoneal Serous Carcinoma: An Unusual Presentation

Introduction Primary peritoneal serous carcinoma (PPSC) is a rare primary malignancy that diffusely involves the peritoneum, indistinguishable clinically and histopathologically from primary serous ovarian carcinoma. Case A 62-year-old female who had menopause 16 years back presented with complaints of lump abdomen. Examination revealed a large (20-22 weeks) solid, irregular, partially mobile, non-tender mass arising out of pelvis. MRI of the abdomen showed a 12.2 x 10.2 x 10.5 cm multiloculated, multiseptated solid cystic mass in pelvis having heterogeneous signal intensity with necrosis and haemorrhage. Ovaries, tubes and uterus were normal. On opening, a 10 9 10 cm solid cystic pelvic mass with irregular surface and adherent omentum was found over the UV fold of peritoneum and was sent for frozen section. Pan hysterectomy, BPLND and omentectomy were done, and peritoneal biopsies were taken. Diagnosis of PPSC was made on the basis of microscopy and immunohistochemistry. Conclusion The prognosis of PPSC is poor. Median survival rate varies between 7 and 27.8 months, while 5-year survival rates range from 0 to 26.5 %.