TY - JOUR
T1 - Primary peritoneal serous psammocarcinoma, rare variant
T2 - A case report
AU - Kancharla, Srujan
AU - Alaniz, Anne
AU - Kothari, Pulin
AU - Norton, Stacy
N1 - Funding Information:
We would like to thank the Houston Methodist System for their support and collaboration with the medical and surgical education of Texas A&M Health Science Center students. We greatly appreciate our expert and collaborative colleagues in the gynecologic oncology and pathology departments. Most importantly, we would like to thank this patient for consenting to publish this report to spread awareness of such a disease process. By extension, we thank all our patients for continuing to trust us with their healthcare and safety daily.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/6
Y1 - 2023/6
N2 - Psammocarcinoma is a rare form of serous carcinoma of the ovary or peritoneum characterized by extensive psammoma body formation seen on histology. A 49-year-old obese woman, gravida 1 para 1 with poorly controlled type 2 diabetes, presented with a history of menorrhagia. She was diagnosed with both leiomyomata and simple endometrial hyperplasia without atypia in the office. Consultation with gynecological oncology and primary gynecologist resulted in a planned hysterectomy with bilateral salpingo-oophorectomy. Laparoscopic hysterectomy and bilateral salpingo-oophorectomy were performed by primary gynecologist. Intraoperative survey of pelvis found concerning nodular lesions seen in posterior cul-de-sac. Lesions were excised and sent for frozen section. Pathology showed invasive peritoneal epithelial implant with psammomatous calcifications. Gynecological oncologist stand-by was called in and proceeded with surgical debulking and staging procedure. Post operatively, the patient has been diagnosed with primary peritoneal low grade serous psammomacarcinoma stage III A2. Her case has been presented to tumor board for multidisciplinary management and is now undergoing adjuvant hormonal therapy utilizing letrozole with chest, abdomen, and pelvic CT scans every 6 months. Standardized protocols are hindered by the rarity of this tumor. Benefits for this oncologic diagnosis are not clearly understood due to the rarity of this tumor. The significance of this case presentation is to highlight the multidisciplinary approach to the workup, diagnosis, treatment (both surgical and medical) and follow up of a rare gynecologic oncologic case. While the surgical team was expecting to find at most significant pathology, an endometrial carcinoma, a rarer primary peritoneal carcinoma was found. Due to the pre surgical planning, and intraoperative teamwork of the pathology, gynecology and oncology teams, this patient received the individualized and disease specific needed surgical and medical care warranted by her unique diagnosis.
AB - Psammocarcinoma is a rare form of serous carcinoma of the ovary or peritoneum characterized by extensive psammoma body formation seen on histology. A 49-year-old obese woman, gravida 1 para 1 with poorly controlled type 2 diabetes, presented with a history of menorrhagia. She was diagnosed with both leiomyomata and simple endometrial hyperplasia without atypia in the office. Consultation with gynecological oncology and primary gynecologist resulted in a planned hysterectomy with bilateral salpingo-oophorectomy. Laparoscopic hysterectomy and bilateral salpingo-oophorectomy were performed by primary gynecologist. Intraoperative survey of pelvis found concerning nodular lesions seen in posterior cul-de-sac. Lesions were excised and sent for frozen section. Pathology showed invasive peritoneal epithelial implant with psammomatous calcifications. Gynecological oncologist stand-by was called in and proceeded with surgical debulking and staging procedure. Post operatively, the patient has been diagnosed with primary peritoneal low grade serous psammomacarcinoma stage III A2. Her case has been presented to tumor board for multidisciplinary management and is now undergoing adjuvant hormonal therapy utilizing letrozole with chest, abdomen, and pelvic CT scans every 6 months. Standardized protocols are hindered by the rarity of this tumor. Benefits for this oncologic diagnosis are not clearly understood due to the rarity of this tumor. The significance of this case presentation is to highlight the multidisciplinary approach to the workup, diagnosis, treatment (both surgical and medical) and follow up of a rare gynecologic oncologic case. While the surgical team was expecting to find at most significant pathology, an endometrial carcinoma, a rarer primary peritoneal carcinoma was found. Due to the pre surgical planning, and intraoperative teamwork of the pathology, gynecology and oncology teams, this patient received the individualized and disease specific needed surgical and medical care warranted by her unique diagnosis.
KW - Insulin dependent Type 2 Diabetes Mellitus
KW - Ovarian cancer
KW - Primary peritoneal
KW - Psammocarcinoma
UR - http://www.scopus.com/inward/record.url?scp=85152270013&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85152270013&partnerID=8YFLogxK
U2 - 10.1016/j.gore.2023.101176
DO - 10.1016/j.gore.2023.101176
M3 - Article
C2 - 37122436
AN - SCOPUS:85152270013
SN - 2352-5789
VL - 47
SP - 101176
JO - Gynecologic Oncology Reports
JF - Gynecologic Oncology Reports
M1 - 101176
ER -