Diagnostics of peritoneal carcinosis
- Preoperative CT Scan
A preoperative CT scan of the chest, abdomen and pelvis with maximal oral and intravenous contrast is of great value in planning treatments for peritoneal surface malignancy. Systemic metastases can be clinically excluded and pleural surface spread ruled out. Nevertheless, the CT scan should be regarded as an inaccurate test by which to quantify the intestinal type of peritoneal carcinomatosis from adenocarcinoma. The malignant tissue progresses on the peritoneal surfaces and its shape conforms to the normal contours of the abdomino-pelvic structures. This is different from the metastatic process in the liver or lung, which progresses as three-dimensional tumor nodules and can be accurately assessed by CT .
However, the CT scan has been of great help in quantifying mucinous adenocarcinoma within the peritoneal cavity . These tumours produce copious colloid material that is readily distinguished from normal structures by shape and by density.