Contrast-Enhanced Ultrasound in the diagnosis of Pseudomyxoma peritonei; a case report

Pseudomyxoma peritonei (PMP) is a rare malignancy marked by mucinous ascites from neoplastic cell dissemination. We report a 50-year-old male with abdominal pain, weight loss, and ascites, initially suspected as hepatic metastases. Imaging revealed peritoneal implants and characteristic liver scalloping, but the percutaneous biopsy was inconclusive. Notably, contrast-enhanced ultrasound (CEUS) reproduced the hepatic scalloping typically seen on CT, helping distinguish mucinous peritoneal deposits from metastatic lesions. The patient's condition worsened and passed away. This case illustrates diagnostic difficulties, the limitations of biopsy, and the potential utility of CEUS in PMP.