Bilateral ovarian masses, massive ascites, and prior appendectomy: must it be ovarian cancer? --a case report of pseudomyxoma peritonei 24 years after appendectomy.

This case report presents a patient who underwent an appendectomy 24 years ago and was later admitted with bilateral ovarian masses and massive ascites. Ovarian cancer was suspected, and surgical intervention was prompted. During the operation, the abdominal cavity was found to be filled with yellow, jelly-like material. Both intraoperative frozen section and postoperative paraffin-embedded pathology confirmed that the ovarian masses were actually mucinous tumors originated from gastrointestinal duct and was clinically diagnosed as pseudomyxoma peritonei (PMP). This case highlights that even in patients with a long history of appendectomy and unremarkable gastrointestinal endoscopy, the possibility of ovarian metastasis from gastrointestinal mucinous tumors leading to PMP should not be overlooked. It also underscores the importance of long-term postoperative follow-up for PMP.