Carcinomatosis

Carcinosis, or carcinomatosis, is disseminated cancer, forms of metastasis,whether used generally or in specific patterns of spread. Carcinomatosis is often restricted to tumors of epithelial origin, adenocarcinomas, while sarcomatosis describes the dissemination of tumors of mesenchymal origin, sarcomas.[1]

When most tumors metastasize to the lung, they form distinct nodules, but about 7% spread through the lymph vessels of the lung.[2]They may impair breathing in several ways; the lung becomes stiffer; blood vessels traveling alongside the distended lymph vessels become compressed.[3]

A pattern of multiple small nodular metastases has been described as miliary carcinosis which has a radiographic appearance similar to miliary tuberculosis.[4] Any potential space may be seeded with tumor cells that grow along surfaces, but which may not invade below the surfaces. In rare cases, the joint spaces are affected.[5]

Different forms of carcinomatosis

The lining of the abdominal cavity is a common site for surface dissemination. Ovarian carcinomas are common. Fluid produced by the cells can produce ascites which is typical in carcinomatosis, but less common in peritoneal sarcomatosis.[1]Fluid can be serous as seen in primary peritoneal carcinoma or mucinous such as found in pseudomyxoma peritonei which is typically a tumor derived from the appendix.[6]

Pleural carcinosis is associated with malignant pleural effusion and poor prognosis.[7]

The meningeal covering of the central nervous system may be the site of tumor growth. Breast cancer, lung cancer and melanoma are the most common tumors.[8]

Colorectal cancer patients with peritoneal involvement can be treated with Oxaliplatin- or Irinotecan-based chemotherapy. Such treatment is not expected to be curative, but can extend the lives of patients[9]. Some patients may be cured through Hyperthermic intraperitoneal chemotherapy, but the procedure entails a high degree of risk for morbidity or death.

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 References

  1. Oei, T. N.; Jagannathan, J. P.; Ramaiya, N.; Ros, P. R. (2010). “Peritoneal Sarcomatosis Versus Peritoneal Carcinomatosis: Imaging Findings at MDCT”. American Journal of Roentgenology. 195(3): W229–W235. doi:10.2214/AJR.09.3907. ISSN 0361-803X.
  2. ^Prakash, P.; Kalra, M. K.; Sharma, A.; Shepard, J.-A. O.; Digumarthy, S. R. (2009). “FDG PET/CT in Assessment of Pulmonary Lymphangitic Carcinomatosis”. American Journal of Roentgenology. 194(1): 231–236. doi:10.2214/AJR.09.3059. ISSN 0361-803X.
  3. ^Mark A. Marinella (7 May 2009). “12. Lymphangitic carcinomatosis”. Handbook of Cancer Emergencies. Jones & Bartlett Learning. pp. 55–57. ISBN 978-0-7637-6989-5. Retrieved 29 February2012.
  4. ^Marks, J. L. (1950). “Metastatic Tumors of the Lung”. Chest. 17(1): 63–73. doi:10.1378/chest.17.1.63. ISSN 0012-3692.
  5. ^Currall, Verity A.; Dixon, John H. (2008). “Synovial Metastasis”. The Journal of Arthroplasty. 23(4): 631–636. doi:10.1016/j.arth.2007.04.034. ISSN 0883-5403.
  6. ^Young, Robert H. (2004). “Pseudomyxoma peritonei and selected other aspects of the spread of appendiceal neoplasms”. Seminars in Diagnostic Pathology. 21(2): 134–150. doi:10.1053/j.semdp.2004.12.002. ISSN 0740-2570
  7. ^Ruffini, E (2002). “The significance of intraoperative pleural effusion during surgery for bronchogenic carcinoma”. European Journal of Cardio-Thoracic Surgery. 21(3): 508–513. doi:10.1016/S1010-7940(01)01166-6. ISSN 1010-7940.
  8. ^Martins, Sandro José; Azevedo, Carla Rameri Alexandre Silva de; Chinen, Ludmilla Thomé Domingos; Cruz, Marcelo Rocha Sousa; Peterlevitz, Marcos Aurélio; Gimenes, Daniel Luiz (2011). “Meningeal carcinomatosis in solid tumors”. Arquivos de Neuro-Psiquiatria. 69(6): 973–980. doi:10.1590/S0004-282X2011000700024. ISSN 0004-282X.
  9. ^Joerg O W Pelz, Terence C. Chua, Jesus Esquivel, et al. BMC Cancer, Volume 10, Published – Dec 22 2010. https://jhu.pure.elsevier.com/en/publications/evaluation-of-best-supportive-care-and-systemic-chemotherapy-as-t-3
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