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Diagnosis and Treatment of Mucinous Appendiceal Neoplasm Presented as Acute Appendicitis

Ioannis Kehagias1, Apollon Zygomalas1, Georgios Markopoulos1

  • 1Department of General Surgery and Department of Radiology, University Hospital of Patras, 26500 Patras, Greece.

Case Reports in Oncological Medicine
|April 12, 2016
PubMed

Insights

Appendiceal mucocele, a rare cause of acute abdomen, requires prompt surgical intervention. This case highlights the importance of considering mucinous appendiceal neoplasms in emergency settings to prevent complications like pseudomyxoma peritonei.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Imaging

Background:

  • Appendiceal mucocele is an uncommon cause of acute abdominal conditions.
  • Mucinous appendiceal neoplasms constitute a small percentage of all appendix specimens.
  • Prompt diagnosis and management are crucial in emergency settings.

Purpose of the Study:

  • To present a case of mucinous appendiceal neoplasm mimicking acute appendicitis.
  • To discuss the clinical and surgical management of this condition in an emergency context.
  • To emphasize diagnostic and therapeutic considerations for appendiceal mucoceles.

Main Methods:

  • Case report of a 72-year-old female with acute abdomen.
  • Diagnostic imaging including abdominal computed tomography (CT) scan.
  • Surgical intervention involving right hemicolectomy and histopathological examination.

Main Results:

  • CT revealed a large cystic lesion in the right iliac fossa with calcified walls.
  • Histopathology confirmed a low-grade mucinous appendiceal neoplasm with negative lymph nodes.
  • The patient had an unremarkable postoperative recovery.

Conclusions:

  • Appendiceal mucocele diagnosis can be aided by Ultrasound and CT, potentially identifying synchronous cancers.
  • Initial surgical management should involve appendectomy, mesenteric fat resection, and cytologic examination of fluid.
  • All mucoceles should be treated as potentially malignant during urgent surgery to prevent iatrogenic perforation and pseudomyxoma peritonei.

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