Introduction

1. Primary Peritoneal Carcinoma found at caeserean section, value of routine abdominal examination at caeserean section Dr R Myagerimath, Dr L Azhar, Miss Nahid Gul, Miss S Mwenechanya Wirral University Teaching Hospital NHS Foundation trust , UnitedKingdom Biopsy and investigations Introduction Primary peritoneal cancer Conclusions • Direct visualization of the peritoneal surfaces along with palpation of the abdominal cavity is by far the most sensitive modality for detecting primary peritoneal cancer. • Caeserean section is an opportunity for direct visualisation and examination of pelvic organs and peritoneal surface. • Any suspicious lesions should be biopsied. • Initial biopsy result - inconclusive • Multi disciplinary team referral • 2nd opinion : suspicious of Papillary serous Carcinoma of ovary • CT scan of abdomen and pelvis did not show any abnormality. • Primary peritoneal carcinoma is a rare malignancy that predominantly affects postmenopausal women. • Typically displays multicentric peritoneal and omental involvement. • Atypical presentations of primary peritoneal carcinoma have been described in English literature. • Here we present an unusual case of primary peritoneal cancer diagnosed in a young asymptomatic woman with suspicious peritoneal lesions at elective caeserean section. MDT Decision / Treatment References • Total abdominal hysterectomy and bilateral salpingoophrectomy with pelvic clearance. • The histology confirmed Primary peritoneal cancer stage 3b with both ovarian and omental involvement. • Post surgery chemotherapy. International Journal of Gynaecological Cancer, September 2007, vol./is. 17/5(1140-1143), 1048-891X;1525-1438 (Sep 2007) Human Reproduction, June 2004, vol./is. 19/6(1472-1475), 0268-1161 (Jun 2004) Papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases.Raju U Fine G, Greenawald KA Ohorodnik JM.Department of Pathology, Henry Ford Hospital, Detroit, MI 48202. Case Report • 37 years old Para 2 , low risk pregnancy • Had an elective caesarean section for previous caesarean section at 39 wks. • During surgery small suspicious peritoneal lesions (vesicles and papules ) were noted • Both ovaries were normal. • Biopsy of peritoneal lesions was taken. Diagnostic dilemmas • The well-documented but rare primary papillary serous peritoneal tumors can present as diagnostic dilemma for both the pathologists and the clinicians as primary peritoneal cancer resembles papillary serous ovarian carcinoma. • Primary peritoneal cancer has same embryologic origin as germinal epithelium of the ovary • The sensitivity of CT scans and ultrasound for peritoneal nodules measuring smaller than one cm is approximately 15-30%. • USG and CT scans, are insensitive for the detection of peritoneal tumours. • The sensitivity of CT and ultrasound for peritoneal nodules measuring smaller than one cm is 15-30%. • CT scan findings are nonspecific. • Treatment of this malignancy is very similar to that of epithelial ovarian cancer i.e combination chemotherapy after optimal cytoreductive surgery. Histology Primary peritoneal cancer