Clinical history Male patient, 59 years old, presenting weight loss with gradual increase of the abdominal volume and uncharacteristic abdominal pain in the past 3 years, without alteration of the intestinal habit. At the physical examination: patient in good conditions, with muscle loss in the upper and lower limbs and voluminous ascites (grade 3). Paracentesis revealed gelatinous and mucinous ascites at the cytologic examination. Increase of CEA and Ca19-9 was found in the laboratory tests. Abdominal and pelvis CT was requested. Image 1: Abdominal computed tomography (CT), axial view, at the T10 level, after intravenous administration of iodinated contrast, arterial phase.Image 2: Abdominal and pelvis CT, axial view, at the L5 level, after intravenous administration of iodinated contrast, arterial phase.Image 3: Abdominal and pelvis CT, coronal reconstruction, mesenteric region, after intravenous administration of iodinated contrast, arterial phase.Image 4: Abdominal and pelvis CT, paramedian sagittal reconstruction, after intravenous administration of iodinated contrast, arterial phase. Question:Considering the clinical history and the provided images, what is the most likely diagnosis? Peritoneal carcinomatosis. Peritoneal tuberculosis. Pseudomyxoma peritonei. Spontaneous bacterial peritonitis. Test Question (Selective Process - Plastic Surgery Medical Residency INCA/2016) - Which one is the best alternative that defines Pseudomyxoma peritonei? Pseudomyxoma peritonei is a rare benign process of the peritoneal cavity that typically arises from an ovarian or an appendiceal adenocarcinoma rupture. Pseudomyxoma peritonei is a rare malignant process of the peritoneal cavity that typically arises from an ovarian or appendiceal carcinoma rupture. Pseudomyxoma peritonei is a rare malignant process of the peritoneal cavity that typically arises from an uterine lesion or a gastric adenocarcinoma. Pseudomyxoma peritonei is a rare benign process of the peritoneal cavity that typically arises from an uterine lesion or a gastric adenocarcinoma Time is Up! Time's up
