1. TEMPLATE DESIGN © 2008 www.PosterPresentations.com Primary Peritoneal Carcinoma found at caeserean section, value of routine abdominal examination at caeserean section Dr R Myagerimath, Dr L Azhar, Miss Nahid Gul, Miss S Mwenechanya Wirral University Teaching Hospital NHS Foundation trust, UnitedKingdom Introduction Diagnostic dilemmas Conclusions References Primary peritoneal carcinoma is a rare malignancy that predominantly affects postmenopausal women. Typically displays multicentric peritoneal and omental involvement. Atypical presentations of primary peritoneal carcinoma have been described in English literature. Here we present an unusual case of primary peritoneal cancer diagnosed in a young asymptomatic woman with suspicious peritoneal lesions at elective caeserean section. Direct visualization of the peritoneal surfaces along with palpation of the abdominal cavity is by far the most sensitive modality for detecting primary peritoneal cancer. Caeserean section is an opportunity for direct visualisation and examination of pelvic organs and peritoneal surface. Any suspicious lesions should be biopsied. MDT Decision / Treatment Total abdominal hysterectomy and bilateral salpingoophrectomy with pelvic clearance. The histology confirmed Primary peritoneal cancer stage 3b with both ovarian and omental involvement. Post surgery chemotherapy. Case Report Histology 37 years old Para 2, low risk pregnancy Had an elective caesarean section for previous caesarean section at 39 wks. During surgery small suspicious peritoneal lesions (vesicles and papules ) were noted Both ovaries were normal. Biopsy of peritoneal lesions was taken. Biopsy and investigations Initial biopsy result - inconclusive Multi disciplinary team referral 2 nd opinion : suspicious of Papillary serous Carcinoma of ovary CT scan of abdomen and pelvis did not show any abnormality. The well-documented but rare primary papillary serous peritoneal tumors can present as diagnostic dilemma for both the pathologists and the clinicians as primary peritoneal cancer resembles papillary serous ovarian carcinoma. Primary peritoneal cancer has same embryologic origin as germinal epithelium of the ovary The sensitivity of CT scans and ultrasound for peritoneal nodules measuring smaller than one cm is approximately 15- 30%. USG and CT scans, are insensitive for the detection of peritoneal tumours. The sensitivity of CT and ultrasound for peritoneal nodules measuring smaller than one cm is 15-30%. CT scan findings are nonspecific. Treatment of this malignancy is very similar to that of epithelial ovarian cancer i.e combination chemotherapy after optimal cytoreductive surgery. Primary peritoneal cancer 1.International Journal of Gynaecological Cancer, September 2007, vol./is. 17/5(1140-1143), 1048-891X;1525-1438 (Sep 2007) 2.Human Reproduction, June 2004, vol./is. 19/6(1472-1475), 0268-1161 (Jun 2004) 3.Papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases.Raju U Fine G, Greenawald KA Ohorodnik JM.Department of Pathology, Henry Ford Hospital, Detroit, MI 48202. Primary peritoneal cancer