This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: JIPMER 2018, Subject name: Surgery
False about pseudomyxoma peritonei is: 
Select and explain. 
A. Omental biopsy for diagnosis, B. Refractory to drugs, C. Hypehemic intraperitoneal chemotherapy is treatment option, D. Most commonly associated with appendiceal tumor
B: Refractory to drugs
Answer: B: Refractory to drugs 
Explanation: Pseudomyxoma peritonei: It is caused due to the rupture of mucinous adenocarcinoma. The most common primary tumor is appendix > ovary. It is the presence of jelly-like substance collected in the cavity and they are usually attached with other abdominal structures. Patient usually presents with abdominal distention, signs/symptoms of paial obstruction, weight loss and occurrence of sudden and multiple hernia (due to increased abdominal pressure) Diagnosis-by omental biospy Staging- PET CT Treatment is usually "Cytoreduction" which includes omentectomy+ peritonectomy+ right hemicolectomy + if female, bilateral salphingo-oophrectomy. If there is recurrence due to residual jelly-like substance after surgery, the treatment is Hypothermic Intra-peritoneal Chemotherapy (HIPEC) which as mitomycin C and cisplatin as impoant agents. Other agents are doxorubicin and docetaxel and these 4 agents are used as single drug or by combination.