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Low-grade appendiceal mucinous neoplasms with bowel obstruction
Constance Houlzé-Laroye1, Clarisse Eveno1,2
1Department of Digestive and Oncologic Surgery, Claude Huriez University Hospital, Centre Hospitalier Universitaire (CHU) Lille, Université de Lille, Lille, France.
Pleura and Peritoneum
|November 1, 2019
Summary
Low-grade appendiceal mucinous neoplasms (LAMN) can present with rare symptoms like intestinal obstruction. This case highlights the importance of considering LAMN in atypical presentations to ensure appropriate surgical management.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Low-grade appendiceal mucinous neoplasms (LAMN) can perforate, leading to pseudomyxoma peritonei, often managed with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
- Early-stage LAMN rarely causes intestinal obstruction or appendiceal infection; abdominal distension is more common in later stages due to mucin spread.
Purpose of the Study:
- To report a rare clinical presentation of LAMN.
- To increase surgeon awareness of atypical LAMN presentations.
- To guide surgical treatment adaptation and referral center assignment for LAMN patients.
Main Methods:
- Case report of a 35-year-old woman with abdominal symptoms mimicking intestinal obstruction.
- Diagnostic workup included abdominal CT scan revealing ileo-caecal intussusception.
- Surgical intervention involved exploratory laparotomy, assessment for mucin spread, and bowel resection.
Main Results:
- Pathology analysis confirmed the diagnosis of LAMN.
- The patient presented with atypical symptoms of intestinal obstruction.
- No evidence of mucin exteriorization was found during surgery.
Conclusions:
- LAMN can manifest with rare clinical presentations, such as intussusception.
- Prompt diagnosis and tailored surgical approaches are crucial for managing LAMN.
- Referral to specialized centers is recommended for optimal patient outcomes.
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