Beyond the Expected: A Case-Based Exploration and Literature Review on the Rare Evolution of Pseudomyxoma Peritonei From a Side-Branch Intraductal Papillary Mucinous Neoplasm.

Abstract

Objectives: We present a case of a ruptured side-branch intraductal papillary mucinous neoplasm (IPMN) who was found to have pseudomyxoma peritonei (PMP) with a deposit of acellular mucin in the pelvis.

Case presentation: The patient is a 65-year-old female who initially presented to care with intermittent right upper quadrant pain and fullness. Preoperative imaging demonstrated a large cystic mass in the pancreatic tail, and, therefore, she was taken to the operating room for a distal pancreatectomy and splenectomy. Intraoperatively, she was found to have two distinct deposits of acellular mucin. Both deposits were nonadherent to the surrounding tissue and removed.

Results: The patient recovered postoperatively without incident. She will be surveilled postoperatively with serial computed tomography.

Conclusion: PMP arising from an IPMN of the pancreas is a rare and potentially devastating complication of the disease. Given the complexity of these cases, a multidisciplinary discussion for ongoing management is essential, and these cases are best managed at centers with significant experience in the management of PMP from other sources.