Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for Pseudomyxoma peritonei originating from ovarian teratomas: A single-center case series and literature review

Abstract

Pseudomyxoma peritonei (PMP) is a complex malignant peritoneal tumor which generally originates from appendiceal mucinous tumors, but can more rarely arise from ovarian mature teratomas. Herein, we evaluated the treatment efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for PMP derived from ovarian mature teratomas. This study retrospectively analysed the clinical data of four patients with a mean age of 50.25 years treated between January 2021 and December 2024. The data included general patient information, surgical details, postoperative pathology, adjuvant therapies, and outcomes. Pathological findings confirmed ovarian mature teratomas in all cases. Peritoneal lesions included one case of acellular mucin, two cases of low-grade PMP, and one case of high-grade PMP with signet-ring cells. All patients underwent CRS with HIPEC treatment with no surgical complications. However, none achieved optimal cytoreduction. During follow-up, the patient with high-grade PMP and signet-ring cells had a postoperative survival time of 12 months, while the remaining patients continue to show good postoperative outcomes. Overall, CRS with HIPEC is a safe and effective treatment strategy for PMP originating from ovarian mature teratomas; even without achieving optimal cytoreduction, this therapy can extend survival and improve quality of life. However, high-grade PMP may require more aggressive treatment.