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[Unusual retrovesical cystic lesion: appendiceal mucocele]
José Gregorio Pereira Arias1, José Gaspar Ibarluzea González, José María Gutiérrez Díez
1Servicio de Urología, Hospital de San Eloy, Vizcaya, España.
Objective:
Retrovesical cystic lesions are uncommon, although its incidence is growing due to the use of current diagnostic techniques. Its clinical features are unspecific and can mimic other conditions of the lower urinary tract making the differential diagnosis of this disease entity is difficult. A case of appendiceal mucocele, an unusual retrovesical lesion, is presented.
Methods/Results:
A 9 x 14 cm right retrovesical cystic lesion suggestive of a seminal vesicle cyst was detected in a 57-year-old patient with polyalkyuria. The patient was symptomatic, therefore surgical exploration was performed and the lesion was resected. The histological analysis of the surgical specimen demonstrated an appendiceal mucocele with no signs of atypia. The literature is reviewed, with special reference to the diagnostic and therapeutic aspects of this lesion.
Conclusions:
We underscore the need to utilize the diagnostic armamentarium (transrectal US, CT, MRI, deferens vesiculography, urethrocystoscopy, colonoscopy, opaque enema, IVP, etc.) to identify retrovesical cystic lesions. Preoperative diagnosis is necessary in appendiceal mucocele to avoid rupture during the surgical procedure and prevent peritoneal pseudomyxoma. Occasionally, however, the definitive diagnosis of these retrovesical lesions can be made only by punction biopsy or surgical exploration.
Insights
Appendiceal mucocele, a rare retrovesical cystic lesion, can mimic other urinary tract conditions. Early diagnosis via imaging is crucial to prevent complications like peritoneal pseudomyxoma.
Area of Science:
- Urology
- Gastroenterology
- Pathology
Background:
- Retrovesical cystic lesions are uncommon but increasingly detected with advanced imaging.
- Their nonspecific clinical presentation complicates differential diagnosis, often mimicking lower urinary tract pathologies.
Observation:
- A 57-year-old male presented with polyalkyuria and a large retrovesical cystic lesion, initially suspected to be a seminal vesicle cyst.
- Surgical resection was performed due to symptomatic presentation.
Findings:
- Histological analysis confirmed the lesion as an appendiceal mucocele without atypia.
- This case highlights appendiceal mucocele as an unusual cause of retrovesical cystic lesions.
Implications:
- Comprehensive diagnostic imaging (ultrasound, CT, MRI) is essential for identifying retrovesical cystic lesions.
- Preoperative diagnosis of appendiceal mucocele is vital to prevent intraoperative rupture and subsequent peritoneal pseudomyxoma.
- Definitive diagnosis may occasionally require biopsy or surgical exploration.