Primary peritoneal serous carcinoma – A rare case report

Primary Peritoneal Serous Carcinoma (PPSC) was first described by Swerdlow in 1959. As the epithelial layer of the ovary and peritoneum derives from common embryonic origin, coelomic epithelium, PPSC is often misdiagnosed as serous carcinoma of ovary. Estimated incidence of PPSC in the United States is 6.78 cases/ 1,000,000 individuals. A 67 years female presented with ascitis. Ultrasonography revealed normal uterus with bilateral adnexae. No pathology was mentioned elsewhere. Ascitic fluid revealed features positive for malignancy. On gross examination, omentum was nodular and firm with no gross pathology in bilateral adnexae. Microscopically, omentum revealed features suggestive of High grade serous carcinoma with tumour deposits in cortical stroma of bilateral adnexae (tumour nests <5 mm2). Hence a diagnosis of High grade serous carcinoma, primary peritoneal was made. Clinico-radiological and histopathological correlation is essential in the diagnosis of PPSC. Diagnosis of PPSC is based on Gynecology Oncology Group criteria (1993). Recognition of this entity becomes important as PPSC is aggressive in nature, debulking surgery and chemotherapy is the only available treatment option.