Peritoneal Malignancies

This chapter focuses on peritoneal malignancies, a group of diseases that originate or spread to the peritoneum, the thin layer of tissue lining the abdomen and covering abdominal organs. Among these, malignant peritoneal mesothelioma (MPM) and peritoneal carcinomatosis (PC) are highlighted due to their clinical significance and challenging management. MPM, a rare cancer associated with asbestos exposure, typically presents in older individuals with nonspecific symptoms such as abdominal pain and distension. Its diagnosis relies on imaging studies like CT scans and confirmatory biopsy. The disease’s diffuse nature and frequent presentation at advanced stages pose difficulties in treatment, which may include cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Despite aggressive management, the prognosis remains poor, with survival often measured in months. PC, on the other hand, represents the spread of various primary cancers to the peritoneum. It is commonly seen in association with gastrointestinal and gynecological malignancies. The presentation of PC is similar to MPM, with abdominal discomfort and ascites being common. Treatment strategies for PC also involve CRS and HIPEC, aiming to reduce tumor burden and improve survival. The efficacy of these treatments is influenced by factors such as the extent of disease and the primary tumor’s biology. Both MPM and PC highlight the complexities of managing peritoneal malignancies, which require a multidisciplinary approach and individualized treatment plans to optimize patient outcomes.