DPAM: Disseminated Peritoneal Adenomucinous
Pseudomyxoma Peritonei
Research, Resources, Referrals and Support
Q: Where can I find a DPAM treatment specialist?
DPAM: Disseminated Peritoneal Adenomucinosis Treatment
Question: What's the difference between PMP and DPAM?
Answer:" The term PMP should be used only as a clinical descriptor for patients who have the syndrome of mucinous ascites accompanied by a characteristic distribution of peritoneal mucinous tumors with the pathologic features of DPAM.
DPAM should be used as a pathologic diagnostic term for patients with the bland peritoneal mucinous tumors associated with ruptured appendiceal mucinous adenomas and PMP.
These patients should not be diagnosed with carcinoma, because they have disease that is distinct pathologically and prognostically from PMCA."
Source:
Cancer. 2001 Jul 1;92(1):85-91.
Ronnett BM, Yan H, Kurman RJ, Shmookler BM, Wu L, Sugarbaker PH.
Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21231, USA. bronnett@jhmi.edu
DPAM Prognosis
DPAM Prognosis
Source: Johns Hopkins University
Excerpt:
Patients with pseudomyxoma peritonei associated with disseminated peritoneal adenomucinosis have a significantly more favorable prognosis than patients with peritoneal mucinous carcinomatosis.
Source: Ronnett B M; Yan H; Kurman R J; Shmookler B M; Wu L; Sugarbaker P H (Profiled Authors: Brigitte Ronnett; Lee Shu Fune Wu; Robert Kurman)
Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21231, USA. bronnett@jhmi.edu
Cancer 2001;92(1):85-91.
Twelve year study of Pseudomyxoma Peritonei Treatment and Disseminated Peritoneal Carcinomatosis with CRS and HIPEC
Source: San Giuseppe Hospital, June 2009
Disseminated Peritoneal Adenomucinosis Treatment with Surgery and Heated Chemotherapy
Source: International Journal of Clinical Oncology, 2009
Disseminated Peritoneal Adenomucinous Treated with CRS and HIPEC
Source: Universite de Montreal, Canada, 2009
DPAM Treatment
Source: Wake Forest University
Survival Study for Pseudomyxoma Peritonei: DPAM, PMCA, PMCA 1
Source: Dr Edward Levine, American Journal of Surgical Pathology, May 2006
Disseminated Peritoneal Adenomucinosis:
Research Focuses on Possible Link Between PMP and Enteric Bacteria (pdf)
Source: Dr Thomas McAvoy and Dr Armando Sardi
Disseminated Peritoneal Adenomucinosis:
Analysis of 109 Cases Peritoneal Dissemination from Appendiceal Neoplasm
Source: Dr John Kane III
Disseminated Peritoneal Adenomucinosis vs Peritoneal Mucinous Carcinomatosis
Refer to the HIPEC page for extensive information about Disseminated Peritoneal Adenomucinosis treatment.
Disseminated Peritoneal Adenomucinous Prognosis
Disseminated Peritoneal Adenomucinosis Prognosis
Disseminated Peritoneal Adenomucinosis General Overview
Source: Annals of Surgical Oncology
Disseminated Peritoneal Adenomucinosis prognosis patients following "second look" surgery
Source: Dr Paul Sugarbaker 2000
Disseminated Peritoneal Adenomucinosis
Cox II expression in patients with Disseminated Peritoneal Adenomucinosis
Source: Dr Brian Loggie
Disseminated Peritoneal Adenomucinosis Definition
Disseminated Peritoneal Adenomucinosis Synonyms
Source: Quest Diagnostics
Diagnosis may be suspected based on physical symptoms,CTscan, tumor marker test. However, the actual diagnosis is confirmed by pathologists after examination of actual tissue and/or mucin or fluid samples.
The diagnosis of Disseminated Peritoneal Adenomucinous aka DPAM indicates the presence of intraperitoneal mucin with epithelium showing low grade atypia.
Tumor CT Grade
What does "tumor grade mean?"
“Tumor grades” distinguish tumor from what appears like normal tissue, when examined under a microscope.
The tumor grade helps physicians predict how quickly the cancer may grow.
G1: well-differentiated tumor cells
G2: moderately differentiated tumor cells
G3: poorly differentiated tumor cells
G4: undifferentiated tumor cells
Tumor grading and staging
Source: NIH
Health Insurance Solutions
Caregiving for DPAM
Disease Free DPAM Pals!
Q&A: What's the Difference Between Adenomucinosis and Adenocarcinoma?
Is DPAM the "true" PMP?
A: Dr. Brigitte Ronnett: "Adenomucinosis is pathologically and prognostic ally very different from adenocarcinoma. Adenomucinosis has very low-grade pathologic features and a better prognosis, although some patients can have more trouble with it than others.
Many patients get diagnosed with "adenocarcinoma" but we would classify these cases as adenomucinosis because they have a much better prognosis (and different pathology) than what we call adenocarcinoma. I hope more pathologists will adopt this classification system so that we can remove some of the mystery surrounding the behavior of PMP."
Q: GG states: "As you know, I write the PMP Pals newsletter from the perspective of patients. For the majority of us, our understanding of this topic (appendiceal cancer and/or Pseudomyxoma Peritonei) is rather limited. However, a clear understanding appears to be limited among local physicians as well.
Some patients become fearful to pursue treatment when they are given a dim prognosis from their local physicians. My goal is to encourage patients to educate themselves about their treatment options, with experienced specialists.
To my understanding, the first step in battling this disease is to confirm the diagnosis, then proceed in locating a qualified and experienced physician for specific treatment."
A: Dr. Brigitte Ronnett: “These are the definitions pertaining to appendiceal cancer and Pseudomyxoma Peritonei:
Adenocarcinoma - malignant tumor that forms glands; this is what we refer to as the aggressive appendiceal tumors in the category PMCA in our papers.
Mucinous adenocarcinoma - a subtype of adenocarcinoma in which the glands have mucinous cytoplasm, sometimes producing abundant extracellular mucin (causing confusion with PMP/DPAM)
Adenocarcinoid - relatively unusual tumor, typically arising in the appendix, named for its histologic similarity to carcinoid tumor of the appendix (and other organs); combines features of carcinoid (usually goblet cell carcinoid) and adenocarcinoma; thought to possibly have behavior between benign and adenocarcinoma, but in our study we found that appendiceal adenocarcinomas with adenocarcinoid appearance usually are infiltrative and aggressive, so we consider them a variant of adenocarcinoma (they have areas that resemble goblet cell carcinoid of the appendix but also can have signet ring cells and others patterns of adenocarcinoma that are aggressive types of mucinous adenocarcinoma)
Disseminated peritoneal adenomucinosis (DPAM) - term created to describe the relatively bland peritoneal mucinous tumor associated with ruptured appendiceal adenomas and PMP; we use this term to distinguish these cases from the more aggressive cases of mucinous adenocarcinoma (PMCA.)
Some pathologists believe what we call DPAM should be called well differentiated mucinous carcinoma in the appendix and peritoneum in PMP cases but this makes the process sound like the other categories of mucinous carcinoma (PMCA and PMCA with intermediate features) and causes confusion; what we call well differentiated mucinous carcinoma (PMCA with intermediate features) is different from DPAM, although these two types can be more difficult to distinguish, and we have shown that DPAM has a better prognosis than the intermediate form of PMCA, warranting separated designation.
I think DPAM is the "true" PMP.”
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