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Abdominal hernia and the unexpected final diagnosis.
Jaime M Cevallos1, Miguel A Moyon1, Nelson E Pozo2
1Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador.
Journal of Surgical Case Reports
|July 7, 2018
Summary
Mucinous cystadenomas of the appendix are rare and can cause pseudomyxoma peritonei. This case highlights the importance of considering appendiceal neoplasm in patients with abdominal masses.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Mucinous neoplasms of the appendix are uncommon, with mucinous cystadenomas accounting for 31-34% of cases.
- These tumors can cause significant appendix dilation and epithelial atypia, with spontaneous perforation occurring in approximately 20%.
Observation:
- A 71-year-old female presented with a palpable upper abdominal mass, initially suspected as a ventral hernia.
- Surgical exploration revealed a mucinous appendiceal mass with free mucin in the peritoneal cavity, a perforated appendix, and a cecal mass.
Findings:
- The patient was diagnosed with pseudomyxoma peritonei, a rare condition resulting from mucin accumulation in the abdominal cavity.
- Despite the extensive findings, the patient experienced a full recovery after surgical intervention.
Implications:
- This case underscores the importance of thorough intraoperative evaluation for unexpected appendiceal pathology, even when a more common diagnosis is suspected.
- Early recognition and surgical management of mucinous appendiceal neoplasms are crucial for preventing complications like pseudomyxoma peritonei.
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