Pathway of peritoneal carcinomatosis maybe hematogenous metastasis rather than peritoneal seeding

Goals: This study aimed to summarize the clinicopathological data of the cases of gastric cancer or colon cancer with regular metastasis in the mesentery of small intestine and explore the pathway of peritoneal carcinomatosis. Materials and methods: We retrospectively analyzed 5 cases of gastric cancer and 3 cases of colon cancer with regular metastasis in the mesentery of the small intestine from January 2014 to June 2016, including clinical information, gross manifestations during operation, treatment, and pathology. Results: The clinical characteristics of all 8 cases were fully collected. The symptoms were various without specificity. All patients were found to present with metastasis in peritoneum during operation and the metastatic lesions arranged along the blood vessels orderly. The metastatic lesions of all studied patients were proved to be malignant carcinoma histopathologically, the same as the original tumor. Tumor emboli were seen in the vessel and invasive neoplastic foci was also seen in the vascular wall. Conclusions: The traditional view that peritoneal carcinomatosis is due to seeding has no sufficient basis. Hematogenous metastasis maybe the real way of peritoneal carcinomatosis combined with clinical presentation.