Torsion of Low-Grade Appendiceal Mucinous Neoplasm (LAMN): A Case Report

Hideo Kidogawa1, Ryo Nonomura1, Keizaburou Maruyama1

  • 1Department of Surgery, Kitakyushu City Yahata Hospital, Kitakyushu, JPN.

Cureus
|January 15, 2025
PubMed

Insights

Low-grade appendiceal mucinous neoplasm (LAMN) is rare, but can cause complications like torsion. This case shows successful laparoscopic resection of a torsed appendix, preventing Pseudomyxoma Peritonei (PMP).

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Pathology

Background:

  • Low-grade appendiceal mucinous neoplasm (LAMN) is a rare appendiceal tumor, diagnosed in 0.08-4.1% of appendectomies.
  • While often asymptomatic, LAMN can lead to acute complications such as torsion or rupture.
  • Appendiceal neoplasms require careful management to prevent spread and recurrence.

Observation:

  • A 33-year-old male presented with upper abdominal pain.
  • Contrast-enhanced computed tomography (CECT) revealed a 3 cm cystic appendiceal lesion with 360° torsion.
  • Laparoscopic surgery confirmed the torsion and allowed for successful appendiceal resection.

Findings:

  • Histopathological examination confirmed the diagnosis of LAMN.
  • The laparoscopic resection was performed without mucin spillage, preventing Pseudomyxoma Peritonei (PMP).
  • The patient experienced an uneventful postoperative recovery and had no recurrence at 2.5 years.

Implications:

  • This case underscores the rarity of LAMN torsion and diagnostic challenges.
  • Advanced imaging like CECT is vital for preoperative identification of appendiceal torsion.
  • Meticulous laparoscopic technique is crucial for successful resection and prevention of PMP.