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Differentiating appendiceal neoplasm from perforated appendiceal diverticulum in chronic appendicitis: a case report
Tracey Edwards1, Phelopatir Anthony1, Nagy Andrawis1
1Department of Surgery, Shoalhaven District Memorial Hospital, Illawarra Shoalhaven Local Health District, Nowra 2541, Australia.
Journal of Surgical Case Reports
|September 24, 2024
Summary
Low mucinous neoplasm of the appendix (LAMN) and appendiceal diverticulum present diagnostic challenges. A multidisciplinary approach is key for accurate diagnosis, distinguishing these rare appendiceal conditions.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Low mucinous neoplasm of the appendix (LAMN) and appendiceal diverticulum are rare appendiceal pathologies.
- Both conditions can mimic appendicitis or be asymptomatic, posing diagnostic challenges.
- LAMN carries risks of pseudomyxoma peritonei and metastasis, necessitating accurate diagnosis.
Observation:
- A 56-year-old woman presented with chronic right iliac fossa pain, initially diagnosed as chronic appendicitis.
- Laparoscopic appendicectomy revealed LAMN on initial histopathology.
- Re-evaluation of histopathology and imaging confirmed a ruptured appendiceal diverticulum.
Findings:
- Initial histopathology can be misleading in differentiating LAMN from other appendiceal pathologies.
- Computed tomography (CT) may show subtle appendiceal dilation, potentially delaying diagnosis.
- A definitive diagnosis requires careful histopathological review and comprehensive clinical evaluation.
Implications:
- Accurate histopathological assessment is critical for appropriate patient management of appendiceal pathologies.
- A multidisciplinary approach, integrating clinical, radiological, and pathological data, is essential.
- Distinguishing LAMN from appendiceal diverticulum impacts prognosis and treatment strategies.
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