Low Grade Primary Peritoneal Serous Carcinoma: A Case Report

Abstract

Background:

Primary peritoneal serous carcinoma (PPSC) is a rare malignancy, predominantly occurring as high-grade tumors. This case report discusses a rare presentation of low-grade PPSC, emphasizing its unique clinical, radiological, and pathological characteristics.

Case Presentation:

A 64-year-old female presented with a year-long history of intermittent abdominal pain, distension, anemia, and melena. Physical examination revealed an indurated mass in the supra-pubic region. Imaging studies showed an infiltrative mass in the infraumbilical region. Serum CA-125 was elevated. Diagnosis was established post-operatively after laparoscopic examination revealed peritoneal nodules. Histopathological and immunohistochemical studies confirmed features of low-grade serous carcinoma. Despite initial treatment response, the patient's condition deteriorated, leading to eventual mortality.

Discussion:

LGSC of the peritoneum is extremely rare. Their presentation with non-specific abdominal symptoms poses diagnostic challenges. Differential diagnosis should include other causes of peritoneal carcinomatosis and metastatic serous carcinomas. While treatment aligns with that of epithelial ovarian cancer, early diagnosis remains a challenge due to non-specific presentation.

Conclusion:

Clinicians should consider PPSC, even its low-grade variant, in differential diagnosis for postmenopausal women with unexplained abdominal symptoms, especially when imaging studies are inconclusive.

Keywords: Primary peritoneal serous carcinoma, Low-grade serous carcinoma, Peritoneum, CA-125, Differential diagnosis, Postmenopausal women.