الفهرس 
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Abstract
Malignant tumours tend to grow quite quickly, and invade into nearby tissues and organs which can cause damage. The original site where a tumour first develops is called primary tumour. Malignant tumours may also spread to other parts of the body to form secondary tumours (metastases) (Bruix, et al 2010).
Carcinomatosis is a condition in which multiple carcinomas develop simultaneously, usually after dissemination from a primary source. Carcinomatosis is usually taken to mean that, there are multiple secondaries in multiple sites (Grossman, et al, 2008).
Either local or distant disseminated malignancy spread could be operable or inoperable depending on may factors such as, general conditions, attachment to either important organ or big vessel, presence of distant metastasis, the site of the tumour is approachable or not and the tumour is respectable or not. Many recent methods make many inoperable cases to be operable. Such as, neoadjuvent chemotherapy, intraoperative chemotherapy, radiotherapy and making graft or bypass of big vessels (Farges., 2009).
An endocytoscope assisted laparoscopic intraoperative diagnosis of disseminated malignancy is a novel accessory tool to the conventional luminal endoscope which provides 450X magnification of the gastrointestinal mucosa, thus allowing in vivo imaging of living cells. It has been used with success in the evaluation of esophageal, gastric, and colorectal mucosal lesions during endoscope (Chak, et al., 2007).
Surgical procedures are sometimes indicated to palliate symptoms without attempting to cure the patient. A palliative operation may be justified to relieve pain, hemorrhage, obstruction, or infection, when it can be done without untoward risk to the patient. The palliative surgical procedures include colostomy, enteroenterostomy, or gastrojejunostomy to relieve obstruction. They also include cordotomy to control pain, cystectomy to control hemorrhagic tumors of the bladder; amputation for intractably painful tumours of the extremities; simple mastectomy for carcinoma of the breast, when the tumor is infected, large, ulcerated, and locally respectable, potentially obstructing colon resection in the presence of hepatic metastases and destruction of liver metastases using radiofrequency ablation (Raphael and Donald., 2003).
In patients with extensive yet isolated local spread of malignancy. Cytoreductive surgery may be of benefit provided that other forms of effective treatment are available for use after surgery, and that reduction of tumour bulk will enhance the effectiveness of these post surgical therapies (Raphael and Donald., 2003).
Chemotherapy is used to kill neoplastic cells-however, there are usually a number of healthy cells which are also killed. The abnormal malignant cells take longer than the normal cells to grow. Therefore, chemotherapy is given in cycles to allow the ”normal” cells to recover. Chemotherapy can be used for curative intent or palliation (Rang and De Bruin., 2008).
Gamma-knife radio surgery is a type of radiation therapy used to treat tumors and other abnormalities in the brain (Sheehan., 2010).