A Rare Case of Low-Grade Appendiceal Mucinous Neoplasm Presenting As Mucinous Vaginal Discharge

Appendiceal mucinous neoplasms (AMNs) are rare tumors that often present with non-specific symptoms, posing diagnostic challenges. This report aims to emphasize the importance of considering AMNs in the differential diagnosis of atypical pelvic symptoms, especially when initial evaluations suggest gynecological issues. A 56-year-old female with a past medical history of hyperlipidemia and a total vaginal hysterectomy performed over 20 years prior for abnormal uterine bleeding due to fibroids presented to her gynecologist with a three-week history of vaginal discharge and pelvic pain. Initial gynecological assessments were unremarkable, prompting a CT scan of the abdomen and pelvis, which revealed a markedly dilated, fluid-filled appendix, indicative of a mucinous neoplasm. The patient underwent laparoscopic right hemicolectomy, which confirmed a low-grade AMN with clear margins. Post-surgical follow-up showed no recurrence, and a surveillance colonoscopy one year later revealed a benign tubular adenoma. This case highlights the need to consider AMNs in the differential diagnosis of pelvic symptoms, particularly when initial gynecological evaluations do not identify a clear cause. AMNs can present with symptoms that overlap with those of gynecological conditions, making accurate diagnosis challenging. Effective management through early recognition and surgical intervention is important to prevent complications. This report demonstrates the value of comprehensive diagnostic evaluation and the importance of including rare tumors in the differential diagnosis of atypical pelvic symptoms.