A case of pseudomyxoma peritonei presenting as ventral and femoral hernia

Chih-Chieh Yen^a, Ming-Che Lee^{a, b}, Chun-Hung Lin^{a, c}, Cheng-Hung Lee^c

^a School of Medicine, Tzu Chi University, Hualien, Taiwan
^b Department of General Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^c Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan

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Abstract
Pseudomyxoma peritonei (PMP) is a unique condition defined by a diffuse collection of mucinous gelatinous fluid in the abdominal cavity. The possible causes of PMP are mucin-producing cells from a ruptured cystadenoma or mucinous malignancies from appendix, colon, pancreas, stomach, and female adnexae. We report a case diagnosed as PMP that presented with multifocal hernias. An 89-year-old woman with history of appendiceal mucinous adenocarcinoma was found to have ventral and femoral hernia. Mucinous jelly-like fluid was found in the hernial sac intraoperatively and we confirmed the diagnosis of PMP via pathology. The symptoms and diagnosis, as well as special features of PMP, are reviewed. Current clinical concepts and treatment strategies are also discussed. The formation of a hernia is perhaps a presentation of PMP that clinicians may easily overlook.

Keywords
Hernia; Mucinous adenocarcioma; Pseudomyxoma peritonei