The natural history of
cystadenocarcinoma of colonic or appendiceal origin was reviewed. This
tumor represents a minimally invasive mucus producing
tumor similar to what is commonly recognized within the bowel lumen as
villous adenoma. This
tumor is usually at an advanced stage at the time of presentation, and tends to recur at the site of
tumor resection and on peritoneal surfaces. The fact that this
tumor does not metastasize hematogenously or lymphatically nor does it invade locally was contrasted to its marked tendency to implant on all abdominal surfaces. The large variations in the efficiency of different types of
tumor dissemination (
metastases, invasion, and spread by implantation) need to be noted for this malignant process. The unique clinical features of
cystadenocarcinoma were reviewed and the particular suitability of intraperitoneal
chemotherapy for its treatment was discussed. Our treatment plan utilizing
cytoreductive surgery and early plus delayed postoperative intraperitoneal
chemotherapy was presented. The surprisingly good results of treatment was discussed. The effects of
chemotherapy on
tumor histology were presented in detain in six patients. Changes induced by intraperitoneal
chemotherapy included a reduction in the number of foci of atypical adenomatous epithelium and marked cytologic
atrophy. This plan of treatment is recommended for patients to prevent or to treat the spread of mucinous
gastrointestinal cancer on peritoneal surfaces and within the resection site of the primary
tumor.