Peritoneal serous papillary carcinoma: a reappraisal of CT imaging features and literature review

We evaluated the imaging features of primary serous peritoneal carcinoma (PSPC) on computed tomography (CT) and reviewed the literature. Preoperative CT images of 11 women with PSPC were retrospectively reviewed. The clinical presentations and serum levels of CA-125 were recorded. Special attention was paid to the operative and histopathologic findings of the ovaries. Imaging features were correlated with those in the literature. An elevation of serum CA-125 was found in 91% of cases. The CT findings included ascites (82%), peritoneal nodules or masses (73%), and omental nodules or omental caking (64%). Absence of an overt ovarian mass was observed in 64% of cases. The clinical manifestations and imaging features in our patients were consistent with those in the literature. Eighty-five percent of the ovaries in our study were superficially involved by PSPC in histopathologic examination. In none of our cases could the ovarian size be clearly assessed in the CT images. In conclusion, the presence of diffuse peritoneal disease and the absence of an ovarian mass on CT and an elevation of serum CA-125 level is suggestive of PSPC. However, in our experience, the evaluation of ovarian morphology and size by CT alone may not be as reliable.