Surgical management of pulmonary metastases in pseudomyxoma peritonei: a case series highlighting the challenges of non-palpable lesions and surgical margin management

Surgical resection can be an effective treatment option for PMP pulmonary metastases; however, careful patient selection and appropriate surgical planning are essential. The unique characteristics of PMP metastases necessitate specific surgical strategies. Since computed tomography-apparent solid nodules may be non-palpable intraoperatively and surgical margin recurrence should be avoided, selecting surgical approaches that minimise unnecessary lung palpation, such as preoperative marking or anatomical lung resection, is crucial. The mechanisms of PMP pulmonary metastasis development and progression remain unclear, warranting further research into blood-borne dissemination patterns and optimal surgical techniques for non-palpable lesions.