A Rare Case of Primary Peritoneal Psammocarcinoma Presenting as Acute Intestinal Obstruction and Ascites

ABSTRACT

We report a rare case of primary peritoneal psammocarcinoma (PPP) in a 60year old female patient who presented to surgical emergency with complaints of inability to pass feces and flatus for last 3 days along with pain and distension of abdomen. On clinical examination there were features of acute intestinal obstruction. Contrast CT of abdomen was suggestive of intestinal obstruction along with a stricture at the recto-sigmoid junction. On exploration there was a growth compressing the recto-sigmoid junction from the serosal surface. Anterior resection of the recto-sigmoid was done with negative gross margins. Histopathological examination of the resected specimen led to a diagnosis of primary peritoneal psammocarcinoma because of a solitary peritoneal lesion having abundant psammoma body formation and normal ovaries visualized on radiology and per-operatively. The diagnosis was further confirmed by histochemical tests and immunohistochemistry along with normal CA-125 levels in the patient.