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Peer-reviewedCC BY-NC-NDBMC gastroenterology

Pseudo-peritoneal carcinomatosis: extensive endosalpingiosis mimicking metastatic dissemination in gastric cancer : a case report and literature review.

  • Saida Sakhri1
  • Eya Ghorbeli2
  • Aya Khemir3,4
  • Fethia Abidi5
  • Hanen Bouaziz2
  • Tarek Ben Dhiab2
5 affiliations
  1. 1Department of Surgical Oncology, Salah Azaiez Institute, Boulevard 9 Avril 1938, Tunis, Tunisia. [email protected].
  2. 2Department of Surgical Oncology, Salah Azaiez Institute, Boulevard 9 Avril 1938, Tunis, Tunisia.
  3. 3Department of Pathology, Salah Azaiez Institute, Tunis, Tunisia.
  4. 4Laboratory for Precision Medicine and Oncology Research (LR21SP01), Tunis, Tunisia.
  5. 5Department of Radiology, Salah Azaiez Institute, Tunis, Tunisia.
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Abstract

Purpose

We report an exceptional diagnostic pitfall in which extensive benign endosalpingiosis mimicked stage IV peritoneal carcinomatosis in a patient with gastric cancer, emphasizing the critical role of histopathological confirmation in staging.Methods

A 57-year-old female was diagnosed with poorly differentiated gastric adenocarcinoma. Initial staging imaging revealed diffuse peritoneal nodules suggestive of carcinomatosis. The patient received perioperative chemotherapy followed by reassessment, with persistent peritoneal lesions, prompting diagnostic laparoscopy with biopsy.Results

Intraoperative findings showed diffuse millimetric peritoneal nodules indistinguishable from metastatic disease. Frozen section and final histopathology demonstrated florid endosalpingiosis without malignancy. Despite a radiological stage IV suspicion, the patient was ultimately confirmed as non-metastatic (M0) and underwent curative-intent total gastrectomy with D2 lymphadenectomy, achieving an R0 resection.Conclusion

Extensive peritoneal endosalpingiosis may closely mimic peritoneal carcinomatosis in gastric cancer. This case highlights the essential role of systematic histological confirmation in preventing incorrect stage IV classification and inappropriate therapeutic management strategies.

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Cite

BibTeXRIS
BibTeX
@article{sakhri2026pseudoperitoneal,
  title = {{Pseudo-peritoneal carcinomatosis: extensive endosalpingiosis mimicking metastatic dissemination in gastric cancer : a case report and literature review.}},
  author = {Saida Sakhri and Eya Ghorbeli and Aya Khemir and Fethia Abidi and Hanen Bouaziz and Tarek Ben Dhiab},
  journal = {BMC gastroenterology},
  year = {2026},
  month = aug,
  doi = {10.1186/s12876-026-05166-w},
  url = {https://europepmc.org/article/MED/42958069},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Pseudo-peritoneal carcinomatosis: extensive endosalpingiosis mimicking metastatic dissemination in gastric cancer : a case report and literature review.
AU  - Saida Sakhri
AU  - Eya Ghorbeli
AU  - Aya Khemir
AU  - Fethia Abidi
AU  - Hanen Bouaziz
AU  - Tarek Ben Dhiab
PY  - 2026
DA  - 2026/08/01
JO  - BMC gastroenterology
DO  - 10.1186/s12876-026-05166-w
UR  - https://europepmc.org/article/MED/42958069
AB  - Purpose  We report an exceptional diagnostic pitfall in which extensive benign endosalpingiosis mimicked stage IV peritoneal carcinomatosis in a patient with gastric cancer, emphasizing the critical role of histopathological confirmation in staging.Methods  A 57-year-old female was diagnosed with poorly differentiated gastric adenocarcinoma. Initial staging imaging revealed diffuse peritoneal nodules suggestive of carcinomatosis. The patient received perioperative chemotherapy followed by reassessment, with persistent peritoneal lesions, prompting diagnostic laparoscopy with biopsy.Results  Intraoperative findings showed diffuse millimetric peritoneal nodules indistinguishable from metastatic disease. Frozen section and final histopathology demonstrated florid endosalpingiosis without malignancy. Despite a radiological stage IV suspicion, the patient was ultimately confirmed as non-metastatic (M0) and underwent curative-intent total gastrectomy with D2 lymphadenectomy, achieving an R0 resection.Conclusion  Extensive peritoneal endosalpingiosis may closely mimic peritoneal carcinomatosis in gastric cancer. This case highlights the essential role of systematic histological confirmation in preventing incorrect stage IV classification and inappropriate therapeutic management strategies.
SN  - 1471-230X
ER  -