Peritoneal carcinomatosis: A malignant disease with an embryological origin?

Surg Oncol. 2015 Sep;24(3):305-11. doi: 10.1016/j.suronc.2015.06.002. Epub 2015 Jun 23.

Abstract

Introduction: In 1931, Simpson et al. coined the term "peritoneal carcinomatosis" to describe the regional spread of ovarian tumors as localized or extended with involvement of the peritoneal serous membrane and neighboring anatomical structures. Research into the origin of peritoneal carcinomatosis is based on two phases in a woman's life: EMBRYO DEVELOPMENT: During week 3, the bilaminar disc becomes a trilaminar disc called the mesoderm. Inside the lateral plate mesoderm, the coelomic cavity is divided into 2 layers: the parietal (somatic) mesoderm, which gives rise to the parietal peritoneum and pleural surfaces; and the visceral (splanchnic) mesoderm, which gives rise to the visceral peritoneum, visceral surface of the pleura, gonadal stroma, and the muscular layer of the hollow viscera and its mesenteries.

Tumor spread: Transcoelomic metastasis and metaplasia of pluripotent stem cells in the peritoneum was involved in the pathogenesis of ovarian cancer. This involvement takes the form of a synchronous malignant transformation at multiple foci and may cause intraperitoneal field cancerization. Pluripotent stem cells play a role both in the development of the embryonic peritoneum and in the spread of transcoelomic tumors. Consequently, knowledge of the origin of these cells (embryonic or current) could be extremely useful. The many markers that act during the embryonic period can affect descendants, that is, cells are already marked before specification and differentiation are activated. Thus, programmed activation could be attributed to genetic and epigenetic changes.

Keywords: Cancer stem cells; Dormant cells; Genetic and epigenetic changes; Lateral plate mesoderm; Ovarian cancer; Peritoneal carcinomatosis.

Publication types

  • Review

MeSH terms

  • Cell Transformation, Neoplastic / pathology*
  • Embryonic Stem Cells / pathology*
  • Female
  • Humans
  • Neoplastic Stem Cells / pathology*
  • Ovarian Neoplasms / pathology*
  • Peritoneal Neoplasms / pathology*