Pseudomyxoma Peritonei Presenting with Femoral Hernias and Peritonitis

Pseudomyxoma peritonei is a rare disease characterized by intraperitoneal accumulation of mucinous ascites produced by neoplastic cells, which mostly originate from an appendiceal adenoma. The clinical presentation of the disease varies, and preoperative diagnosis is often difficult. This report describes a 76-year-old female patient with pseudomyxoma peritonei who presented with lower abdominal pain and bilateral femoral masses. Computed tomography revealed bilateral femoral hernias and fluid collection in the peritoneal cavity. Laparotomy was performed, during which we found extensive diffuse gelatinous material mixed with purulent ascites, and the diagnosis of pseudomyxoma peritonei was confirmed. The disease is rarely associated with femoral hernias or peritonitis. Its clinical presentation, including the characteristic findings on computed tomography, and surgical management are briefly reviewed.