Appendiceal mucoceles and pseudomyxoma peritonei.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Appendiceal mucoceles represent a spectrum of appendiceal neoplasms.
• These lesions can range from benign cystadenomas to malignant cystadenocarcinomas.
• Associated pseudomyxoma peritonei presents unique diagnostic and management challenges.

Purpose of the Study:

• To analyze the clinical presentation, diagnosis, and outcomes of patients with appendiceal mucoceles.
• To evaluate the impact of pseudomyxoma peritonei on patient survival.
• To determine optimal surgical management strategies for appendiceal mucoceles.

Main Methods:

• Retrospective review of eight patients treated for appendiceal mucocele between 1983 and 1990.
• Histopathologic classification into cystadenoma and cystadenocarcinoma.
• Correlation of clinical data, diagnostic imaging (ultrasound), tumor markers (CEA), and surgical outcomes.

Main Results:

• Five cystadenocarcinomas and three cystadenomas were identified; three cases had pseudomyxoma peritonei.
• Pseudomyxoma peritonei was diagnosed preoperatively in two of three patients using ultrasound and paracentesis.
• Elevated carcinoembryonic antigen (CEA) levels aided in recurrence detection.
• Cystadenoma patients remained disease-free post-appendectomy.
• Cystadenocarcinoma patients treated with right colectomy experienced recurrences, with one death due to pseudomyxoma peritonei complications.

Conclusions:

• Appendiceal mucoceles have diverse histopathology and prognoses.
• Pseudomyxoma peritonei is a critical factor negatively impacting survival.
• Aggressive and potentially repeated surgical intervention is indicated for appendiceal mucocele with pseudomyxoma peritonei.