Laparoscopy-assisted resection of an appendiceal mucinous cystadenoma

We present a 48-year-old man with a complaint of dull right-lower abdominal pain who was diagnosed with mucocele of the appendix. He underwent laparoscopy-assisted resection of the tumor. In the procedure, the entire right colon was freed from the retroperitoneal structures without rupturing the tumor; and ileocecal resection and anastomosis were performed extracorporeally. The pathological diagnosis of the tumor was mucinous cystadenoma of the appendix, measuring 9.0 cm × 8.0 cm × 4.0 cm. The postoperative course was uneventful, and he had no recurrent disease at a 2-year follow up. When resecting an appendiceal mucinous tumor laparoscopically, it is essential (1) to keep the tumor intact during manipulation, and to use a wound-protecting device when delivering the lesion; (2) to consider the extent of tumor resection with a negative surgical margin as well as prophylactic lymph node dissection in cases of suspected adenocarcinoma, even though the oncological adequacy of the laparoscopic procedure for carcinoma remains to be elucidated; and (3) to check whether any mucinous fluid has accumulated in the abdominal cavity, which represents an indication for open surgery.