Gravity is another important redistribution mechanism, which facilitates the accumulation of tumor cells in the pelvis, such as the rectovesical pouch or the pouch of Douglas. It is termed as the so-called ‘redistribution phenomenon.’ The intraperitoneal fluid is most frequently reabsorbed through the right paracolic gutter toward the right hemidiaphragm and the greater and lesser omentum, thus becoming the major sites of tumor deposits when cells get trapped in small lymphatic systems.

Free-floating mucinous epithelial tumor cells then implant in various parts of peritoneal cavity following the intraperitoneal fluid current and gravity, thanks to their absence of adhesive properties.

Initially, tumor cells originating from the mucinous epithelium of the appendix continuously produce mucus into the appendiceal lumen and form a mucocele, which eventually ruptures. There are several steps involved in the pathogenesis of pseudomyxoma peritonei. Females are affected more frequently than males. Patients have an average age of 53 years at the time of diagnosis. The primary site is identified predominantly as mucinous appendiceal adenocarcinoma. The estimated incidence of pseudomyxoma peritonei is approximately 1 to 4 out of a million annually. KRAS mutation has also been present in 70 % of appendiceal adenomas. Patients with familial adenomatous polyposis (FAP) demonstrate an increased risk of developing mucinous adenocarcinoma of the appendix. Pseudomyxoma peritonei merits consideration as a ‘borderline malignancy’ with changing prognosis based on the site of origin. Due to its indolent behavior, pseudomyxoma peritonei is often discovered incidentally with a relatively advanced stage during laparoscopy, laparotomy or imaging studies for other medical concerns. However, currently, it has been more widely used to describe peritoneal dissemination of mucus-producing neoplasm most frequently from the appendix, but also small and large bowel, stomach, pancreas, lung, breast, gallbladder, fallopian tubes, and ovaries. It was initially believed to arise from a perforated cystadenoma of the appendix. Werth first introduced the term pseudomyxoma peritonei in 1884. Pseudomyxoma peritonei (PMP) is a rare clinical entity, characterized by diffuse intra-abdominal gelatinous ascites, the so-called “jelly belly,” with mucinous implants on peritoneal surfaces.

Explain the importance of improving care coordination amongst interprofessional team members to improve outcomes for patients affected by pseudomyxoma peritonei.

Summarize the management considerations for patients with pseudomyxoma peritonei.

Outline the typical presentation of a patient with pseudomyxoma peritonei.

Describe the pathophysiology of pseudomyxoma peritonei.

This activity outlines the evaluation and management of pseudomyxoma peritonei, and highlights the role of the interprofessional team in improving care for patients with this condition.

Proper diagnosis and management of pseudomyxoma peritonei can majorly impact a patient's lifespan and quality of life. Pseudomyxoma peritonei (PMP) is a rare clinical entity characterized by diffuse intra-abdominal gelatinous ascites with mucinous implants on peritoneal surfaces.

Pmp cancer