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Subperitoneal adenomucinosis following proctocolectomy for ulcerative colitis
E Ronan Ryan1, Keyanoosh Hosseinzadeh, Mona Bansal
1Division of Abdominal Imaging, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. ryaner@upmc.edu
Journal of Magnetic Resonance Imaging : JMRI
|June 24, 2011
Summary
Subperitoneal adenomucinosis is a rare condition where mucin accumulates outside the peritoneal space. This case highlights a benign perineal mass resulting from prior rectal mucosa retention, successfully managed with surgical excision.
Area of Science:
- Gastroenterology
- Oncology
- Radiology
Background:
- Adenomucinosis involves mucin accumulation, typically linked to appendiceal mucinous neoplasms within the peritoneum.
- Extraperitoneal adenomucinosis is an uncommon variant, often occurring post-surgery for mucinous appendiceal neoplasms.
Observation:
- A case of subperitoneal adenomucinosis presented as a slow-growing, boggy perineal mass.
- The mass resulted from retained rectal mucosa 16 years after proctocolectomy for ulcerative colitis.
Findings:
- Contrast-enhanced magnetic resonance imaging (MRI) localized the mass to the pelvis.
- MRI revealed no solid enhancing components, indicating benignity.
- The imaging facilitated accurate local surgical excision, preventing peritoneal dissemination.
Implications:
- This case expands the understanding of extraperitoneal adenomucinosis origins, linking it to retained mucosa post-proctocolectomy.
- Accurate preoperative MRI is crucial for planning benign lesion excision and avoiding complications.
- Subperitoneal adenomucinosis can be a rare, benign sequela of prior gastrointestinal surgery.
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